Coordination of Benefits (COB) & Secondary Claims
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Data statusReference Only
- Status
- Reference Only
- Data year / effective
- General revenue-cycle practice
- Last reviewed
- May 2026
- Last updated
- May 2026
- Primary source
- Industry revenue-cycle practice
- Formula notes
- Determining payer order under the Medicare Secondary Payer rules — working aged (employer 20+), disability (employer 100+), and ESRD (first 30-month coordination period), plus workers’ comp, no-fault, and liability — then billing the primary first, billing the secondary with the primary’s payment data and MSP value codes, COBA crossover through the BCRC, and reconciling to patient responsibility. Employer-size thresholds, the ESRD clock, and value codes are general references that change — verify the current rules and codes against CMS, NUBC, and your MAC / payer.
- Known exclusions
- A general workflow — adapt to your payers, system, and policy
- Not exhaustive; settings and contracts differ