View the COB Language Definition

For secondary and tertiary payors, the expected payment is determined by specific COB language that is included in most contracts. The Coordination of Benefits Language Definition page displays the calculation and calculation method for a specific COB language type. For a list of all available language types in Contract Manager, refer to COB Language Types.

Note: This page is only accessible if COB is enabled for your facility. For more information about COB, refer to Coordination of Benefits.

Use the following procedure to view the calculation method for a specific account.

  1. Access the Patient Account Audit page for an account with a secondary or tertiary payor.
    1. If you know the account number:
      • Select Go To > Account Research > By Account Number. The Account Research by Account Number page opens.
      • Type the account number and click Display Account. The Patient Account Audit page opens.
    2. If you do not know the account number:
      • Select Go To > Account Research > from Worklist. The Account Research from Worklist page opens.
      • From the Task list, select Create Worklist.
      • Specify other selection criteria and click Display Accounts. The Account Worklist page opens. For more information about search criteria, refer to Specify Account Worklist Criteria.
      • Click the account number you want to review in the Account Number column. The Patient Account Audit page opens.

        Note: PEM claims are not included in worklist results.

    3. Click the Coordination of Benefits Language link in the Payor Summary section. The Coordination of Benefits Language Definition page opens.
  2. Review the calculation and calculation method for the selected language type.

The following table describes each of the fields on the Coordination of Benefits Language Definition page. The fields are listed in alphabetical order.

Field

Description

Calculation

The actual calculation used to derive the expected reimbursement for accounts using this language type

Calculation Method

A short description of how the expected reimbursement is calculated for this language type

Calculation Type

The calculation language type defined for this payor in the contract profile. For a list of all available language types, refer to COB Language Types.