1
Which COB Rule does the below statement applies:
Rule 2 is Dependent Child of Parents Not Separated or Divorced, also known as The Birthday Rule
When do we transfer a caller from Providers Office to Provider Services Dept.?
if they mentioned that they already followed the steps but still misrouted to Member Services Dept.
Mom and Dad are now separated. A court decree states that Mom has the physical custody of the child. However, child lives with the Dad most of the time. Which parent's insurance pays first?
Mom
Medicare has how many parts and what are those?
A - IP
B - OP
C - ADVANTAGE
D - RX
A 66 year old member has Medicare and a plan through his employer that has 19 employees. Who pays first?
Medicare
Mary has a COBRA plan through her previous employer with 150 employees. Mary now work at Sit-sit with less than 20 employees and having UHC as the insurance provider. Who pays first?
UHC
A daughter is a dependent to both of her parents plan. Mom and Dad are not divorced nor separated. Which insurance is the daughter's primary?
Depends which parents has the earliest Birthday (Month and Day only).
First to do Mock Call for today. If you're done, your name needs to be entered back in the Wheel of Fortune.
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COB has __ rules.
7
TRUE or FALSE?
UHC pays first if the member has active UHC coverage through an employer group with 20 or more employees and Medicare Plan due to age.
TRUE
Wife is a dependent on his Husband's Medicare Plan. Wife has her own insurance plan through her employer with 15 employees. Who pays first?
Medicare
NEXT PERSON PLEASE!!
NEXT ROUND IS YOURS. :-)
KANAAAAAAAAAAAAAAAA
If none of the preceding rules determine primary or secondary status, the plans shall share the allowable expenses equally. Also known as?
Rule 7 is Shared Expense.
John used to work with Lazada and had BCBS as his insurance. John got laid off and enroll his BCBS Plan to COBRA. When John was working with Amazon, he has a Type 2 Diabetes. John is now working at Shopee with UHC as his new and additional insurance. John went to his doctor and was ordered to have an MRI due to a car accident. Who pays first?
UHC
A member who have Language Disorder has both Medicare and UHC Plan through her employer with 230 employees. Who pays first?
UHC
Mary is a dependent on John's plan through his active employment. Mary has her own insurance plan through her previous employer which she enrolled to COBRA. Mary's Primary Insurance is ______ ?
COBRA | Rule 5 is COBRA Continuation of Coverage. When member is a spouse on an active plan, but is the subscriber on a COBRA plan, the plan in which member is subscriber would be primary over plan with active coverage.
What are the qualifications for Medicare?
Age - 65yrs old and above
Disability
ESRD
Originator: Mother, not on the plan
Subject: Daughter, 5 yrs. old
Scenario: Mom is calling to check benefits for her daughter. No need to get Verbal Auth since Mom is only calling for Gen. Info and daughter is only 5yrs. old. TRUE or FALSE
Get Verbal Auth from the Subscriber
You received a call from Maria. Maria is the main subscriber and was able to fully verify the plan. However, Maria's voice sounds like a man. Do we ask Maria if she is really Maria?
NO!!!! WE do not discriminate!
John joined Aling Bebe's Fishball on 01/15/2025 his UHC plan started on 07/01/2025. John also worked at Mang Kanor's Pares Overload on 02/20/2025 and his BCBS plan started on 05/01/2025. John's primary insurance is?
BCBS |
A 75 year old member has both Medicare and Cobra Plan. Which pays first?
Medicare
John used to work with Lazada and had BCBS as his insurance. John got laid off and enroll his BCBS Plan to COBRA. When John was working with Amazon, he has a Type 2 Diabetes. John is now working at Shopee with UHC as his new and additional insurance. John went to his doctor to have an Insulin shot. Who pays first?
BCBS COBRA
Mom and Dad are now separated. There were no Court Decree. The child stays with Dad 3/7 days a week. Child's primary insurance is _____ plan.
Mom's
A blind employee has both Medicare and a COBRA plan through his previous employer with 75 employees. Who pays first?
Medicare
Free Point
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