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Submitting COB claims

When we are secondary to Medicare or another insurer, submit the claim to the primary insurer first. When you receive the primary insurer’s EOB, send the secondary claim according to instructions.

Refer to our billing guidelines or 837 Companion Guide for field/data requirements. Additional tips for COB claims appear below.

For claims involving workers’ compensation or auto accidents, refer to our third-party liability information.

When we are not the primary insurer

If the primary insurer You should By this time
Paid the claim or allowed more than $0 Submit the COB claim (see tips below) Within one year of the date the other insurer processed the claim
If the primary insurer And You should By this time
Denied the claim or paid/ allowed nothing You can submit the claim to us within timely filing limits Submit the COB claim (see tips below) Within timely filing limits
The claim is beyond timely filing limits Combine your appeal with your claim.  Send the following documents to the appropriate appeals address.
  • Within 90 days of the other insurer’s processed date for HMO/POS or PPO
  • Within one year of the processed date for Indemnity or dental claims

When we are primary

Follow standard claim submission guidelines for claims within timely filing limits.

If your claim is But You should By this time
No longer within our timely filing limit You submitted a claim to another insurer within the timely filing limit and you have an EOB with their denial date Combine your appeal with your claim.  Send the following documents to the appropriate appeals address.
  • Within 90 days of the other insurer’s denial date for HMO/POS or PPO
  • Within one year of the denial date for Indemnity or dental claims

Tips for electronic COB claims

  • You must report:
    • The primary insurer’s name and address
    • And the insured member’s ID number
  • If the other insurer paid, report the amount paid by the other insurer at the claim’s line level.
  • If the claim was denied by the primary insurer, report the reject reason.

Dentists:

  • Do not attach Pre-Treatment Estimates when submitting your COB claim. Only EOBs are accepted.
  • Please provide all required information in your claim. Including the National Electronic Attachment (NEA) number is helpful, but not required.

Methods for submitting electronic COB claims

If you submit electronic claims this way Be sure to
Web-based tool Refer to the primary claim and secondary claim instructions in the tool’s user guide
Clearinghouse Confirm with your clearinghouse that COB data entered in your software is transmitted to Blue Cross
EDI transaction (Direct Connection) Review the section, “Coverage Secondary to Medicare or Other Payers,” in our 837 Companion Guide

Online Services: You cannot submit 1500 claims involving coordination of benefits using the Direct Data Entry tool.

Dental Connect: We do not currently provide claim submission through Dental Connect; however, you can purchase this functionality through Change Healthcare.

Tips for paper COB claims

Be sure to:

  • Enter the other insurer’s information on your claim form as required in our billing guidelines
  • Mail the claim form with the other insurer’s EOB attached.
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