Coordination of Benefits

When coverage is available from more than one source, providers often feel a false sense of security that at least one source will pay. In these situations, private payers aware of other coverage, race to pay secondary, i.e., lesser, benefits. It is not uncommon for multiple payers to claim responsibility for secondary payment, while neither payer makes primary payment. Despite multiple payers with responsibility, provider and patients often experience denials from both!

TGF identifies applicable state and federal laws as well as private contract language that controls these disputes. We work with both payers to ensure proper primary and secondary payment and full reimbursement and coverage for providers and patients.


  • Providers often feel a false sense of security that one source pay when coverage is available from more than one source
  • When multiple sources of coverage exist it is not uncommon for insurers to dispute primary liability—resulting in denials from both payers
  • TGF will consult with both insurers and develop a solution after considering the insurers’ COB provisions and applicable COB state laws