The Coordination of Benefits Agreement (COBA) Program established a standard contract between CMS and other health insurance organizations that defines the criteria for transmitting enrollee eligibility data and Medicare adjudicated claim data for the purposes of coordinating benefits. In 2006, the CMS fully transferred the claims crossover functions from individual Medicare fee-for-service contractors to a national claims crossover contractor, the Benefits Coordination & Recovery Center (BCRC). This consolidation allowed for the establishment of unique identifiers (COBA IDs) to be associated with each contract and payer line of business, and created a national repository for COBA information.
COBA Trading Partners are issuers of an insurance policy that supplements Medicare or a State agency responsible for administration of Title XIX of the Social Security Act. They may also be a federal agency, or contractor thereof, that administers and provides health care benefits for its eligible beneficiaries or an entity working under contract with a self-insured employer plan or an insurer to adjudicate claims and perform other insurance functions, including those required for coordination of benefit activities. A COBA Trading Partner does not include entities that merely receive, route, and/or translate files, such as health care clearinghouses, network service vendors, data transmission services, and billing services.
If you are interested in becoming a COBA Trading Partner, please contact the BCRC’s Electronic Data Interchange (EDI) Department to discuss COBA service options which will be customized to your organization. The BCRC’s EDI Department’s telephone number is 1-646-458-6740.