BC Advantage - 2022 Issue 10

DENIED! CO 22-This care may be covered by another payer, per coordination of benefits?!?

Coordination of benefits can be described as when two or more insurance plans work together to determine the order of coverage liability. This coordination between plans exists to avoid duplicate payment, which could result in a provider receiving payment in excess of the services provided and the total amount billed.    In circumstances where there is more than one potential payer, not submitting claims to the proper payer will lead to denial reason code CO-22, this care may be covered by another payer, per coordination of benefits.The National Association of Insurance Commissioners (NAIC) offers a wealth...

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