Coordination of Benefits - Child Health Plus, Essential Plan, Metal-Level Products
2024/9/17
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Posted by Provider Relations
Fidelis Care would like to remind providers of claim submission guidelines regarding Coordination of Benefits (COB) for Child Health Plus, Essential Plan, and Metal-Level products.
Child Health Plus: In accordance with the terms of the Subscriber Contract for Child
Health Plus, no coordination of benefits will occur for claims submitted when another carrier is primary. This includes Medicare, any other governmental program, commercial or self-funded policies.
Essential Plan and Health Benefit Exchange: In accordance with the terms of the Subscriber Contracts for the Essential Plan and Health Benefit Exchange, no coordination of benefits will occur for claims submitted when Medicare or any other governmental program is primary (except Medicaid).
For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist. Thank you for being a valued Fidelis Care partner in the provision of quality care.