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Announcing New York State Coordination of Benefits Agreement (COBA) Program Implementation
6/10/2022 • Posted by Provider Relations

The Coordination of Benefits Agreement (COBA) program establishes a uniform national contract between CMS, benefit programs and other health insurers. COBA is a standard processing methodology used by the national Medicare community. COBA allows greater efficiency and simplification via consolidation of the claims crossover process.

Under COBA, Medicaid providers will submit claims for Medicare/Medicaid eligible beneficiaries to the Medicare fee-for-service claims system for processing. Medicare will:

  • Process the claim
  • Apply any deductible/coinsurance or co-pay amount
  • Forward the claim to Fidelis Care for further claims processing. 

For claim types included in the COBA agreement, providers will no longer need to bill Medicaid separately for the Medicare deductible, coinsurance or co-pay amounts. Please note, it is crucial that providers provide the appropriate NPI number and TIN on the claim form in order to ensure seamless processing by Fidelis Care.

If you have any questions, please contact your Fidelis Care Provider Relations Specialist, or connect with our Call Center at 1-888-FIDELIS (1-888-343-3547).

 

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