235.033 Coordination of Benefits

235.033

Coordination of Benefits: The Texas Medical Association will work with payers to (1) encourage expedited payment policies and streamline the coordination of benefit process by requiring that employers provide employee attestations directly to the health plans in a timely manner and also provide an option for insured members to provide this information directly to the health plan via a form or other electronic means and that all claims be immediately processed and paid by a health plan regardless of the lack of coordination benefit attestation information on file from the employer and/or insured members; and (2) streamline the proof of full-time student status by requiring that employers provide proof of full-time student status directly to the health plans in a timely manner and also provide an option for insured members to provide this information directly to the health plan via electronic means. Further, TMA should work with payers to encourage that all claims be immediately processed and paid by the health plan regardless of the lack of proof of full-time student status information on file from the employer and/or insured member (CSE Rep. 2-A-11).

Last Updated On

October 07, 2016