The provision of health insurance policies that specifies which coverage is primary or secondary is called which of the following?

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Multiple Choice

The provision of health insurance policies that specifies which coverage is primary or secondary is called which of the following?

Coordination of benefits is the arrangement that decides which health insurance plan pays first when a person has more than one policy. When multiple policies cover a patient, one plan is designated as the primary payer and the other as the secondary. The primary plan handles its allowed amount up to its limits, and the secondary plan may cover remaining eligible charges, such as deductibles and coinsurance, up to its own limits. This prevents double payments and gaps in coverage, ensuring the claim is paid fairly across plans. Beneficiary enrollment is simply enrolling in a plan, not about payment order. Benefit threshold isn’t the term for how plans coordinate payments, and a capitation agreement describes a provider payment model, not payer coordination.

Coordination of benefits is the arrangement that decides which health insurance plan pays first when a person has more than one policy. When multiple policies cover a patient, one plan is designated as the primary payer and the other as the secondary. The primary plan handles its allowed amount up to its limits, and the secondary plan may cover remaining eligible charges, such as deductibles and coinsurance, up to its own limits. This prevents double payments and gaps in coverage, ensuring the claim is paid fairly across plans.

Beneficiary enrollment is simply enrolling in a plan, not about payment order. Benefit threshold isn’t the term for how plans coordinate payments, and a capitation agreement describes a provider payment model, not payer coordination.

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