Coordination of Benefits Agreement definition

Coordination of Benefits Agreement and “COBA” each means the contract required to be entered into, pursuant to 42 CFR § 438.3(t), by and between Contractor and CMS that establishes the order in which Contractor and CMS will pay for the claims of Full Benefit Dual Eligible Members. By entering into a Coordination of Benefits Agreement and obtaining a COBA number, Contractor will be able to participate in the automated crossover claims process.
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Examples of Coordination of Benefits Agreement in a sentence

  • AgeWell New York, LLC is a Health Maintenance Organization (HMO) plan with a Medicare contract and a Coordination of Benefits Agreement with New York State Department of Health.

  • Effective July 6, 2004, the COBC will begin to send copies of the Coordination of Benefits Agreement Insurance File (COIF) to the nine CWF host sites on a weekly basis.

  • Bright Health’s New York D-SNP plan is an HMO with a Medicare contract and a Coordination of Benefits Agreement with New York State Department of Health.

  • The com position o f this b u ild in g had a w idespread influence in N orth A m erica, and a m ore restrained version term inates St. G eo rg e 's Street, C ape Town.

  • Refer to the COBA Implementation User Guide on the Coordination of Benefits Agreement website to reference the Section 111 Drug Eligibility Record specification and layout.

  • Include your responsible reporting entity (RRE) ID(s) below that is/are used in association with expanded Section 111 MMSEA reporting: □ Trading Partner or the separate entity named above and in Section V will submit the drug eligibility record through this Coordination of Benefits Agreement via the E02 format no later than 90 days from the COBA production date.

  • CWF Receipt and Processing of the Coordination of Benefits Agreement Insurance File (COIF)Effective July 6, 2004, the Benefits Coordination & Recovery Center (BCRC) began to send copies of the Coordination of Benefits Agreement Insurance File (COIF) to the nine CWF host sites on a weekly basis.

  • If the Reporter has entered into a Coordination of Benefits Agreement (COBA) with CMS, it may opt to submit secondary prescription drug coverage using either the COBA or a VDSA.

  • However, trading partners should submit their inquiries through the Coordination of Benefits Agreement Problem Inquiry Request Submission process to ensure prompt attention.

  • See Appendix A.1 for document links.Complete Technical Readiness SurveyWhen new to the COBA program, the trading partner should initially use the Coordination of Benefits Agreement (COBA) Program Technical Readiness Assessment Survey to report its current technical ability in relation to the COBA technical requirements as outlined in this guide.

Related to Coordination of Benefits Agreement

  • Coordination of Benefits or “COB” means a provision establishing an order in which plans pay their claims, and permitting secondary plans to reduce their benefits so that the combined benefits of all plans do not exceed total allowable expenses.

  • Assignment of Benefits means an arrangement whereby the Plan Participant assigns their right to seek and receive payment of eligible Plan benefits, in strict accordance with the terms of this Plan Document, to a Provider. If a provider accepts said arrangement, Providers’ rights to receive Plan benefits are equal to those of a Plan Participant, and are limited by the terms of this Plan Document. A Provider that accepts this arrangement indicates acceptance of an “Assignment of Benefits” as consideration in full for services, supplies, and/or treatment rendered.

  • Severance Agreement means the Key Executive Severance Agreement, dated as of the date hereof, between the parties, as it may be amended from time to time, that provides for certain benefits related to termination of the Executive’s employment that are unrelated to a Change of Control.

  • Transition Agreement has the meaning set forth in Section 12.8.1.

  • Terms-of-service agreement means an agreement that controls the relationship between a user and a custodian.

  • Schedule of Benefits means the section of this policy which shows, among other things, the Eligibility Requirements, Eligibility Waiting Period, Elimination Period, Amount of Insurance, Minimum Benefit, and Maximum Benefit Period.

  • Termination Agreement has the meaning set forth in the Recitals.

  • Implementation Agreement means the Implementation Agreement dated ……… by and between the GOB, PGCB and the Company in connection with the Project, and also includes any amendment of it made from time to time;

  • Salary Reduction Agreement means an agreement between a dis- trict and an employee to reduce the employee’s salary for the pur- pose of making direct contributions to or purchases of a qualified investment product. Art. 6228a-5, Sec. 4(5), Tex. Rev. Civ. Stat.

  • Foundation Agreement means the agreement dated the 20th February 1985 made between the Trustee, the Manager, Xxxxxxxx, Genting WA and Tileska providing for the subscription of Units and Options;

  • Master Separation Agreement has the meaning set forth in the recitals.

  • the Second Supplementary Agreement means the Second Supplementary Agreement, a copy of which is set out in Schedule 3;

  • Supplementary Agreement means the agreement of which a copy is set out in the Fifth Schedule;

  • Change of Control Agreement means the Change of Control letter agreement between the Company and the Executive of even date herewith.

  • Addendum Agreement is defined in Section 8.2.

  • Designation Agreement means a designation agreement in substantially the form of Exhibit G attached hereto, entered into by a Bank and a Designated Lender and accepted by the Administrative Agent.

  • Separation and Distribution Agreement has the meaning set forth in the Recitals.

  • Addendum / Amendment means any written amendment / addendum /corrigendum to this RFP, from time to time issued by NMRC to the prospective bidders

  • Change in Control Agreement means a written Change in Control Agreement between an employee and the Company or an Affiliate.

  • Mediation agreement means a written agreement between the parties to a mediation meeting.

  • the First Variation Agreement means the agreement a copy of which is set forth in the Second Schedule;

  • Cooperation Agreement means that certain Mortgage Loan Cooperation Agreement, dated as of the Closing Date, among Borrower, Lender and Sponsor, as the same may from time to time be amended, restated, replaced, supplemented or otherwise modified in accordance herewith.

  • Separation Agreement has the meaning set forth in the recitals to this Agreement.

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • the Second Variation Agreement means the agreement a copy of which is set forth in the Third Schedule;

  • Services Agreement means an agreement entered into between a Utility and one or more Affiliates for the provision of Shared Services or For Profit Affiliate Services and shall provide for the following matters as appropriate in the circumstances: