Workflows · Financial

Coordination of Benefits (COB) & Secondary Claims

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Reference OnlyBrowser-onlyNo PHI
No PHI

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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
Browser-onlyNo PHI
0 of 0 resolved
A general workflow — adapt the steps to your setting, payers, and policy. Do not record patient identifiers here.