HNE Updates
its COB Process

Health New England has changed its procedures to automate the coordination of benefits ("COB") process. In connection with these changes, we have reviewed and revised our COB policies. These changes will not alter the processing of Medicare claims.

Under the new procedures, HNE will enter into its system the following information:
Primary insurer’s allowed amount, deductible amount, coinsurance and copayment amount paid by the primary insurer.

The system will then automatically adjudicate the claim. HNE will pay either what is left of the provider's bill or the difference between the primary insurer’s payment and our regular benefit (our "Provider Allowed Amount"), whichever is less. The provider receives this entire amount; we will not deduct any risk (withhold) or any applicable HNE copayment from the amount we pay. Any applicable user fee will be deducted based on HNE’s Provider Allowed Amount.