Example: A patient has Anthem Blue Cross and claims are submitted to them as the primary claim. Anthem may keep the claim pending requiring the patient or member to contact them to explain whether they have another insurance plan. What Anthem is saying is they want to verify there is not another plan that may the patient’s primary plan and should therefore be paid first.
The patient MUST contact Anthem in this example, or they will not make payment. It may seem as just a way to avoid paying the claim. However, if you look at what may happen, and all too often does is, a patient comes in with an insurance and the insurance makes payments for the claims. A year goes by and they do a take-back stating there was another insurance that was primary. Now the patient has disappeared and can no longer provide that other insurance information to get claims to that other carrier.
Solution: A COB is easily resolved, a phone call from the member will take care of the issue. It may also keep the insurance company from doing a take-back down the road. A necessary but easy resolution to what could become a costly issue later.
Pro Tip: Always follow through on insurance requests, if a patient refuses to handle a problem do not continue and hope the issue resolves itself. Verify they have contacted the insurance company and resolved whatever the problem may be. Do not take their word for it, they will often say they called when they haven’t. Verify it.