The Coordination of Benefits (COB) Contractor's trained staff will help you with your COB questions. Whether you need a question answered or assistance completing a questionnaire, the Customer Service Representatives are available to provide you with quality service Monday through Friday, from 8:00 a.m. to 8:00 p.m., Eastern Time, except holidays, at toll-free lines:1-800-999-1118 or TTY/TDD: 1-800-318-8782 for the hearing and speech impaired.

Address general written inquiries to:

MEDICARE - Coordination of Benefits
P.O. Box 5041
New York, NY 10274-5041

Please mail questionnaires and correspondence to:

MEDICARE - COB
Data Match Project
P.O. Box 33848
Detroit, MI 48232

MEDICARE - COB
Initial Enrollment Questionnaire Project
P.O. Box 17521
Baltimore, MD 21203-7521

MEDICARE - COB
MSP Claims Investigation Project
P.O. Box 33847
Detroit, MI 48232

MEDICARE - COB
Voluntary Agreement Project
P.O. Box 660
New York, NY 10274-0660

Other Addresses for the COBC:

Medicare – Coordination of Benefits

Employer/Insurer Outreach

P.O. Box 660

New York, NY 10274

Medicare- Coordination of Benefits

Small Employer Exemptions

P.O. Box 660

New York, NY 10274

CMS c/o COBC

WCMSA Proposal/final settlement

P.O. Box 33849

Detroit, MI 48232

 In order to better serve you, please have the following information available when you call:

• Beneficiaries – Your full name, date of birth, Health Insurance Claim Number (HICN)/Medicare Claim Number (located on your Medicare card below your name) and one additional piece of information such as SSN, address, Medicare effective date(s), whether you have Part A and/or Part B coverage.
• Providers – Your Medicare provider number (UPIN/OSCAR/NSC). If you cannot furnish a provider number that matches our database, you will be asked to submit your request in writing. Prior to releasing any Private Health Information about a beneficiary, you will need the beneficiary's last name and first initial, date of birth, HIC number, and gender.
• Attorneys – Requests for information regarding a beneficiary must come in as a written request in order to verify the relationship.  If the request is on file, you will be requested to supply your  client's full name, date of birth, Health Insurance Claim Number (HICN)/Medicare Claim Number (located on your client's Medicare card below their name) and one additional piece of information such as SSN, address, Medicare effective date(s), whether your client has Part A and/or Part B coverage.
• Insurers – Prior to releasing any Private Health Information, the beneficiary's file will be reviewed to verify that you are the insurer of record.  You will need to provide the beneficiary's full name, Date of Birth, Health Insurance Claim Number (HICN), and one addition piece of information such as SSN, address,  effective date(s), whether you have Part A and/or Part B coverage Note: An insurer will only be able to obtain information where it is the insurer of record.
• Employers – Prior to releasing any Private Health Information, the beneficiary's file will be reviewed to verify that you are the employer of record.  You will need to provide the beneficiary's full name, Date of Birth, Health Insurance Claim Number (HICN) and one addition piece of information such as SSN, address, Medicare effective date(s), whether the beneficiary has Part A and/or Part B coverage Note: An employer will only be able to obtain information when it is the employer of record.

Note: If you are unable to provide the correct information, we cannot release any beneficiary specific information. You will be advised that the beneficiary's information is protected under the Privacy Act, and we will not release the information. We can only provide answers to general COB or MSP questions.

What Information Will the COB Contractor Assist You With?

 All Customers

• Answers to general questions regarding Medicare Secondary Payer (MSP).
• Requests for duplicate questionnaires.

Beneficiaries

• Answers to questions regarding the Initial Enrollment Questionnaire (IEQ), Secondary Claim Development (SCD) questionnaires, and Trauma Development (TD).
• Information regarding other payers that may be primary to Medicare's primary/secondary status.
• Reporting any changes to your health coverage
• Reporting a liability, auto/no-fault, or workers' compensation (WC) lawsuit.

Providers

• Verification of Medicare's primary/secondary status. Note: Insurer information will not be released. The provider must request information on payers primary to Medicare from the beneficiary prior to billing. Since we must protect the rights and information of our beneficiaries, we cannot disclose this information.
• Reporting changes to a beneficiary's health coverage.
• Reporting a beneficiary's accident/injury.

Employers

• Answers to questions regarding Data Match and Voluntary Data Sharing Agreements (VDSAs).

Attorneys

• Answers to questions regarding Secondary Claim Development (SCD) questionnaires or Trauma Development (TD) questionnaires.
• Information regarding the lead contractor assigned to your client's case.
• Reporting an accident/injury.

GHP Insurer

• Updating MSP records where you are the insurer of record.
• Answers to questions regarding Voluntary Data Sharing Agreements (VDSAs).

Non-GHP Insurers

• Reporting a beneficiary's accident/injury.

What Information Will the COB Contractor Be Unable to Provide?

 Beneficiaries

• Information regarding denial of a claim or service on your claim for a reason other than MSP - contact 1-800 Medicare.
• Information regarding replacement of your Medicare card, enrolling in Medicare, changing your address, or verifying Medicare coverage - contact the Social Security Administration (SSA) at 1-800-772-1213, Monday through Friday, from 7:00 a.m. through 7:00 p.m., Eastern Time.
• General Medicare information, information about Medicare health plan choices, and information on ordering Medicare publications - contact 1-800-Medicare.

Providers

• Information concerning how to bill for payment (e.g., value codes, occurrence codes) - contact the local Medicare contractor for this information.
• Contact the local Medicare contractor regarding inquiries related to specific claims or recoveries.
• Information regarding beneficiary entitlement data. Current regulations do not allow the COB Contractor to provide entitlement data to the provider.
• Insurer information. The COB Contractor is permitted to state whether Medicare is primary or secondary but cannot provide the name of the other insurer. It is very important that the provider obtain this information from the beneficiary since the new Privacy Act prohibits the release of this information.

Attorneys

For Medicare's interest regarding a liability, auto/no-fault, or workers' compensation (WC) lawsuit you must contact the lead contractor.  Lead contractor info is supplied to you via a letter from the Coordination of Benefits Contractor once you've been identified as the beneficiary's attorney.  If you did not receive a letter and need to know who the lead contractor is, call the COBC at 1-800-999-1118.

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Page Last Modified: 06/12/2008 8:25:03 AM
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