Coordination of Benefits Claims: Include Required Data Elements
Tufts Health Public Plans, Tufts Health Plan SCO, Tufts Medicare Preferred
Tufts Health Plan is enhancing the processing of Coordination of Benefits (COB) claims submitted via EDI. The new process will allow for electronic COB claims to be accepted and auto adjudicated — resulting in streamlined submission and processing of these claims.
For appropriate adjudication of COB claims, complete and accurate information from the primary payer claim is required. Effective for claims received on or after Feb. 1, 2023, Tufts Health Plan will require that COB claims include the data elements listed below. Claims submitted without this information will be rejected.