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Coordination of Benefits Regulation Adopted—Will Reduce Claims Denials

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The long-awaited coordination of benefits (COB) regulation has been adopted by the State Insurance Department (SID) and will apply to all claims initially submitted on or after July 15. COB refers to obtaining payment when more than one insurer shares responsibility for paying a claim. The regulation will reduce administrative denials associated with COB for health insurance claims. HANYS negotiated this regulation with other stakeholders and issued comments supporting it. The regulation provides specific steps and timeframes for both payers and providers to follow when there appears to be more than one health plan responsible to pay for medical services provided. Contact: Stacey Mahany Montalto

Published April 3, 2009