Certified Revenue Cycle Representative (CRCR) Practice Exam

What is the purpose of Coordination of Benefits (COB)?

1. To streamline patient billing processes

2. To determine payment responsibility among multiple plans

3. To establish healthcare networks

4. To track patient insurance changes

The correct answer is: To determine payment responsibility among multiple plans

The purpose of Coordination of Benefits (COB) is primarily to determine payment responsibility among multiple insurance plans when a patient is covered by more than one policy. This process ensures that claims are paid correctly and helps to avoid overpayment or duplication of benefits. When multiple insurance plans are involved, COB guidelines establish which plan pays first (the primary payer) and which pays second (the secondary payer), along with any other applicable policies. This coordination is essential for ensuring that healthcare providers receive accurate and timely reimbursement while also protecting patients from being billed for services more than once when multiple insurances are involved.