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| COBA Program and Medigap - EDI Services |
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Coordination of Benefits (COB) refers to a Centers for Medicare & Medicaid Services (CMS) initiative to identify the health benefits available to a Medicare beneficiary, and to coordinate the payment process between insurers.
Two programs have been set up to forward information from Medicare to a beneficiary's supplemental insurance company: COBA Program and Medigap.
The Coordination of Benefits Agreement (COBA) Program
The Coordination of Benefits Agreement (COBA) Program establishes a nationally standard contract between the Centers for Medicare & Medicaid Services (CMS) and other health insurance organizations that defines the criteria for transmitting enrollee eligibility data and Medicare adjudicated claim data. CMS has transferred the claims crossover functions from individual Medicare contractors to a national claims crossover contractor, the Coordination of Benefits Contractor (COBC). This consolidation allows for the establishment of unique identifiers (COBA IDs) to be associated with each contract and create a national repository for COBA information.
Questions regarding supplemental claims and subscriber eligibility should be directed to the supplemental payer/insurer. For a point-of-contact list of trading partners enrolled in the COBA program, visit the CMS Web site at www.cms.hhs.gov/COBAgreement/Downloads/Contacts.pdf  .
Additional information regarding the COBA program can be found by reading the following articles, which were published in the Medicare B Hotline Bulletin, the Upstate Medicare Division's (UMD's) quarterly bulletin to the provider community:
Medigap
Effective October 1, 2007, the Centers for Medicare & Medicaid Services (CMS) will transfer the mandatory Medigap insurance claim-based crossover process from its Medicare contractors to the national Coordination of Benefits Contractor (COBC). Please see the links below for more information.
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