When do we ask coordination of benefits questions?

Coordination of benefits questions are essential for all patients because they help healthcare providers determine which insurance plan is the primary and which is the secondary payer. This process ensures that the patient's claims are processed correctly and that the appropriate payments are made for medical services.

Regardless of the type of insurance a patient has—be it Medicare, commercial insurance, or even being uninsured—coordination of benefits is critical when there are multiple insurance plans involved. Understanding the patient's complete insurance situation enables healthcare providers to bill the correct insurance first and helps prevent claim denials or delays in payment.

In cases where patients have more than one insurance plan, failing to ask coordination of benefits questions could lead to misprocessing of claims, resulting in unexpected out-of-pocket costs for the patient. Therefore, it's crucial to ask these questions for every patient to ensure proper billing and maximize their benefits.