Aetna sent out the message below last week so I thought I would pass it on.
June 28, 2019
We’d like to let you know that incomplete and erroneous electronic Coordination of Benefits (COB) claims submissions are resulting in processing and payment delays.
Incomplete and erroneous COB submissions have significantly affected our claims auto-adjudication process and has resulted in delayed payments while waiting for additional information from a billing provider or billing vendor.
We’ve noticed an increase in the number of electronic claims submitted with a “Y” response in the COB indicator field.
- A “Y” response in the COB indicator field should be
entered only if other coverage exists.
- All subsequent COB data fields must be populated as well, including the name of the other carrier, the name of the subscriber’s employer, and the corresponding policy number.
- If the patient does not have other coverage, an “N”
must be populated in the COB indicator field.
- All subsequent COB data fields should be left blank. Random characters or symbols must not be populated in these fields.
- Please review your systems to ensure the COB indicator field isn’t pre-populated with a “Y” response. If so, please remove the automatic designation. The appropriate response for each new claim submission must be entered as outlined in the information above.