Wiki Cob

coder1

Guru
Messages
160
Location
MIAMI
Best answers
0
Hello Coding World,

Could anyone give me advice on how to handle a coordination of benefits issue. I have patients, who are very sick and are not able to call COB to update there benefits. Most of our patient was on a working beneficary/spouse plan which termed and is medicare primary. The problem is until its updated by patient, Mcr keep denying the claim.

If patient is in Nursing home shouldn't the Case Manager or social worker be able to help updated COB?


Thanks in advance
 
As long as you have a signed release from the patient in the files and you know the exact date the job terminated (retirement date) and when the Medicare began then you should be able to update it also. This is what I have been told so let's see what others have to say.
 
If you dont have any luck with updating, you may be able to bill the termed commercial insurance and send in to Medicare with the primary denial.
 
Top