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CoordinationofBenefitsQuestionnaire Groupware EmployeeName Employee ID PatientName Providence Date(s)service ClaimNumber AlliedBenefitSystems, Inc.istheclaimsprocessorfortheemployergrouphealthplan(Plan).
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What is coordination of benefits questionnaire?
The coordination of benefits questionnaire is a form used by insurance companies to determine which insurance plan should pay first when a patient is covered by more than one insurance plan.
Who is required to file coordination of benefits questionnaire?
The primary policyholder is required to file the coordination of benefits questionnaire if they are covered by more than one insurance plan.
How to fill out coordination of benefits questionnaire?
To fill out the coordination of benefits questionnaire, the primary policyholder must provide information about all insurance plans they are covered by, including policy numbers and coverage details.
What is the purpose of coordination of benefits questionnaire?
The purpose of the coordination of benefits questionnaire is to prevent duplicate payments by ensuring that the correct insurance plan is billed first for any medical expenses.
What information must be reported on coordination of benefits questionnaire?
The coordination of benefits questionnaire typically requires information such as insurance company names, policy numbers, effective dates, and coverage details for each plan.
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