What is the primary purpose of coordination of benefits in UB-04 submissions?

• A. To identify the hospital's billing rules.
• B. To prioritize payer payments based on contract penalties.
• C. To ensure all payers review the claim before payment.
• D. To coordinate payments across multiple insurers and determine the correct order of liability.

Answer: (D)

Coordination of benefits handles situations where a patient has more than one health insurance plan. Its purpose is to determine which insurer pays first (the primary payer) and how the other insurers contribute (the secondary and any tertiary), so the total payments align with the patient’s coverage and the allowed charges. This ordering and coordination prevent duplicate payments and ensure each policy’s rules are followed, resulting in proper liability across all payers on the UB-04 claim. The other options miss this core role: COB isn’t about identifying the hospital’s own billing rules, nor about penalties driving payments, nor does it require all payers to review the claim before payment—the key function is coordinating who pays first and how subsequent payments are applied.