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The new Coordination of Benefits Agreement (COBA) Program establishes a nationally standard contract between CMS and other health insurance organizations that defines the criteria for transmitting enrollee eligibility data and Medicare adjudicated claim data. The CMS will transfer the claims crossover functions from individual Medicare contractors to a national claims crossover contractor, the Coordination of Benefits Contractor (COBC). This consolidation will allow for the establishment of unique identifiers (COBA IDs) to be associated with each contract and create a national repository for COBA information. The COBA crossover consolidation initiative has been implemented on a small-scale (a parallel-production pilot test) effective July 6, 2004. On that date, ten COBA trading partners began serving as beta-site testers for the COBA pilot test. During the COBA pilot test, numerous Health Insurance Portability and Accountability Act (HIPAA) ANSI-X12N 837 COB issues were identified and remedied. COBA trading partners will begin testing on a monthly basis. Trading partners are moved to production when testing is complete and they are prepared internally to move to the COBA consolidated claims crossover process. How the Coordination of Benefits Agreements WorksThrough the consolidated claims crossover (or COBA) process, trading partners will no longer need to submit separate eligibility files to CMS' local Medicare contractors to identify their covered members nor will they receive numerous identifiers and crossover claim files or separate invoices from these entities. Trading partners will continue to generate eligibility files using the same format that is currently in effect but updated to include drug coverage information. The COBC will transfer claims to trading partners in the HIPAA ANSI-X12N 837 COB (version 4010-A1) and National Council for Prescription Drug Programs (NCPDP) version 5.1 batch standard 1.1 formats. All eligibility file-based trading partners will be transitioned from their existing crossover agreements with Medicare contractors to national COBAs throughout Fiscal Year (FY) 2005 starting no earlier than April 2005. After transitioning all eligibility file-based trading partners to the consolidated COBA process, CMS' current plan is to also consolidate at a national level the Medigap claim-based crossover process. Enroll in the COBA ProgramTo get started, simply click on the links at the bottom on the page. For additional information about the COBA program, email us at COBVA@GHIMEDICARE.COM or contact the COBC at 1-800-999-1118 or TTY/TDD 1-800-318-8782 for the hearing and speech impaired, Monday through Friday, from 9:00 a.m. - 5:00 p.m., Eastern Standard Time, except holidays.
Page Last Modified: 08/14/2008 9:16:38 AM
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