Coordination of Benefits

Coordination of Benefits (COB) Assistance By BCRC (Benefits Coordination & Recovery Center)

Coordination of Benefits (COB) issues can be consolidated by BCRC (Benefits Coordination & Recovery Center) that will correct any possible issues on their end, or report to the contractor any issues that require action on the part of the contractor. The Contractor can verify whether Medicare claims processing records indicate crossover; however, when our records indicate that claims did not crossover, we cannot provide any specifics on the trading partner’s criteria.

Because Medicare no longer crosses over claims, you will need to contact the Trading Partner so they may investigate the situation to confirm if it is an internal issue or an issue with the BCRC.

The CWF includes the eligibility file that contains specific information pertaining to the trading partner contracted with the BCRC. As Medicare claims are processed, CWF applies each COB Trading Partner’s claims selection criteria against the Medicare claim. The COBA ID of the trading partner and their eligibility file data are stored in CWF. The eligibility file is sent from the Trading Partner to the BCRC. The file contains data to identify the claims for cross over.

BCRC assist you with:

  1. All Customers
    • Answers to general questions regarding Medicare Secondary Payer (MSP).
    • Requests for duplicate questionnaires.
  2. Beneficiaries
    • Answers to questions regarding the Initial Enrollment Questionnaire (IEQ), Secondary Claim Development (SCD) questionnaires, and Trauma Development (TD).
    • Information regarding other payers that may be primary to Medicare’s primary/secondary status.
    • Reporting any changes to your health coverage
    • Reporting a liability, auto/no-fault, or workers’ compensation (WC) lawsuit.

     

  3. Providers
    • Verification of Medicare’s primary/secondary status. Note: Insurer information will not be released. The provider must request information on payers primary to Medicare from the beneficiary prior to billing. Since we must protect the rights and information of our beneficiaries, we cannot disclose this information.
    • Reporting changes to a beneficiary’s health coverage.
    • Reporting a beneficiary’s accident/injury.

To learn more about EDI and become a certified  EDI Professional please visit our course schedule page.

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