EDI COB Center For Celerian Group Companies Customers, Beneficiaries And Providers
EDI COB Center Assistance is given for CGS (Celerian Group Companies) contractors regarding EDI Coordination of Benefits issues. EDI COB Center Assistance (Benefits Coordination & Recovery Center) is provided to:
- Answers to general questions regarding Medicare Secondary Payer (MSP).
- Requests for duplicate questionnaires.
- 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.
- 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 Celerian Group Companies must protect the rights and information of its beneficiaries, Celerian Group Companies cannot disclose this information.
- Reporting changes to a beneficiary’s health coverage.
- Reporting a beneficiary’s accident/injury.
EDI COB Center will not assist in following cases:
- Information regarding denial of a claim or service on your claim for a reason other than MSP – contact 1-800 Medicare.
- Information regarding replacement of your Medicare card, enrolling in Medicare, changing your address, or verifying Medicare coverage
- General Medicare information, information about Medicare health plan choices, and information on ordering Medicare publications.
- Information concerning how to bill for payment (e.g., value codes, occurrence codes) – contact the local Medicare contractor for this information.
- Contact the local Medicare contractor regarding inquiries related to specific claims or recoveries.
- Information regarding beneficiary entitlement data. Current regulations do not allow the BCRC to provide entitlement data to the provider.
- Insurer information. The BCRC is permitted to state whether Medicare is primary or secondary but cannot provide the name of the other insurer. It is very important that the provider obtain this information from the beneficiary since the new Privacy Act prohibits the release of this information.