COB & TIMELY FILING Flashcards

1
Q

determines which carrier is primary and which carrier is
secondary for a claim
prevents duplicate payments,
underpayments, or overpayments

A

Coordination of Benefits (COB)

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2
Q

pays the remaining balance if there are any

A

Secondary Payer

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3
Q

this important to determine during the insurance verification process to avoid potential delays

A

Primary & secondary insurance designations

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4
Q

Medicare uses this feature to expedite processing of claims that have more than one payer

A

Crossover claims

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5
Q

has the authority to specify the primary plan of a child or dependent when both caretakers have health insurance

A

Court order

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6
Q

it is when the organization is required to submit a claim to the insurance plan for services

A

Timely filing

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7
Q

How long does the timely filing takes place?

A

typically 30 days to 1 yr

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8
Q

Medicare & TRICARE has how long filing limits?

A

1 year

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9
Q

Commercial plans has how long filing limits?

A

less than 1 year

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10
Q

this helps to explain Medicare policies in an easy-to-understand format

A

Medicare Learning Network (MLN)

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11
Q

they have the resources for coding & billing guidance

A

Medical Administrative Contractors (MAC)

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