Question

multiple choice question

what explains how an insurance policy will pay if more than one policy applies?

assignment of benefits
coordination of benefits
advanced beneficiary notice
explanation of benefits

Explanation:

Define the core problem

The question asks for the term that explains how insurance policies pay when a patient is covered by more than one policy.

Analyze the options

Using the Primary Insurance and Secondary Insurance knowledge points

• Assignment of benefits: An agreement where a patient directs their insurance company to pay the healthcare provider directly.
• Coordination of benefits: A process used by insurance companies to determine which plan pays first (primary) and which pays second (secondary) when a patient has multiple policies, preventing duplicate payments.
• Advanced beneficiary notice: A notice given to a Medicare patient showing that Medicare is unlikely to pay for a specific service.
• Explanation of benefits: A document sent by an insurer to a patient explaining what medical treatments and/or services were paid for on their behalf.

Select the correct term

The term that specifically coordinates payments between multiple active policies is Coordination of benefits (COB).

Answer:

• (A) Assignment of benefits
• (B) Coordination of benefits (Correct answer)
• (C) Advanced beneficiary notice
• (D) Explanation of benefits