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Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process

Through this instruction, CMS is requiring the Common Working File (CWF) to display all COBA bypass exclusion indicators within the Health Insurance Master Record (HIMR) claim detail screens. In addition, through this instruction 1) the CWF maintainer shall now begin to display crossover disposition indicators on HIMR even when COBA trading partners are in "test" mode with the COBC, with one noted exception; 2) Part A shared system shall modify the formatting of the special provider notification letters that it creates following Part A contractor receipt of Coordination of Benefits Contractor Detailed Error Reports (COBC DERs); and 3) at CMS’s direction, the Coordination of Benefits Contractor (COBC) will modify the COBA Insurance File (COIF) to allow for separate displays of Test/Production indicator claim versions; and expand the bytes available for "error description" within the COBC Detailed Error Report layouts for 837 institutional and professional claims.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 20, 2009

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