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Overview

The 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 has transferred the claims crossover functions from individual Medicare contractors to a national claims crossover contractor, the Coordination of Benefits Contractor (COBC). This consolidation allows for the establishment of unique identifiers (COBA IDs) to be associated with each contract and create a national repository for COBA information.

How the Coordination of Benefits Agreements Works

Trading partners generate eligibility files using the same format that documented on the Eligibility File Format page also included drug coverage information. For those beneficiaries listed on the eligibility file 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.

Enroll in the COBA Program

To get started, simply click on the links at the bottom on the page, and review subsections listed on the left hand column. For additional information about the COBA program, email us at COBVA@EHMEDICARE.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.


Downloads

COB Agreement (pdf 158KB)

COBA Attachment (pdf 479KB)

COBA Implementation User Guide (pdf 1.7MB)

HIPAA Closed Disagree Issues Log (pdf 157KB)

HIPAA Closed Agree Issues Log (pdf 298KB)

Trading Partner Customer Service Point-of-Contact List (pdf 100KB)

Technical Readiness Survey (pdf 124KB)

Termination Procedures (pdf 61KB)

Medigap Claim-based COBA IDs for Billing Purpose [pdf, 60KB]
Related Links Inside CMS

COB - General Information
Related Links Outside CMS

There are no Related Links Outside CMS

 

Page Last Modified: 04/24/2009 1:26:10 PM
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