For Medicare Part A, the data center which handles claims from an FI (fiscal
intermediary) obtains/maintains COB data and generates a COB file, from which an
837 is generated for the secondary (or tertiary) payer(s) , where the previous
payer info is added in the 2320/2330 loops (and a couple of other places. I
don't have my documentation handy for the 837 COB software I wrote for a
Medicare part A FI client, but it's available at the Medicare EDI web site).
(Just so you are aware: there are some new rules on COB which go into effect
with full HIPAA implementation, like a requirement the FI or payer 'tank'
EVERYTHING which comes in from the provider so that it can be included on any
COB claim generated down the road. But that's getting ahead of myself).
As I "think" about it, though, it seems to me the logical place for COB data to
be kept would be with the payer: after all, it's their subscriber/member and I'd
think they would keep the data on "other insurance coverage this
member/subscriber has." But, providers often ask patients for "secondary
coverage information" before they will slap on the band-aid or kiss the boo-boo.
Not that it's any of my business, but are you a payer or provider? Do you
request "secondary insurance info" from your patients (if you are a provider) or
members (if you are a payer)?
Michael Mattias
Tal Systems Inc.
Racine WI USA
[EMAIL PROTECTED]
----- Original Message -----
From: Chandra Damera <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Thursday, August 16, 2001 6:26 PM
Subject: Question on 837
> Hi all,
>
> Scenario : A 837 professional claim doesn't include
> COB info.
> Question : Is there a situation where 'Other Payer
> info' is transmitted in the 2320/2330 Loops?!
>
> Any thoughts appreciated!
>
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