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COORDINATION OF BENEFITS CERTIFICATION FORMEmployee Name:
Employee Contact Information:
Employees Department:
Spouse/Espouse Name:
Spouse/Espouse Address:
Spouse/Espouse Employer:
Spouse/Espouse Employer
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What is coordination of benefits certification?
Coordination of benefits certification is a process used by health insurance companies to determine the order of payment when a person is covered by more than one insurance plan.
Who is required to file coordination of benefits certification?
Health insurance companies and individuals with dual coverage are required to file coordination of benefits certification.
How to fill out coordination of benefits certification?
Coordination of benefits certification can be filled out online or submitted through mail by providing information about the primary and secondary insurance coverage.
What is the purpose of coordination of benefits certification?
The purpose of coordination of benefits certification is to avoid duplicate payments and ensure that claims are paid correctly by the insurance companies.
What information must be reported on coordination of benefits certification?
Information such as policy holder's name, insurance policy numbers, coverage effective dates, and details of any other insurance coverage must be reported on coordination of benefits certification.
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