Since 1/2 we’ve had about 18% of our BCBS and Aetna claims kicked back for COB, even when eligibility shows active primary in Availity. Are you auto-sending a patient questionnaire at the first 277CA pend or waiting for a second request to avoid premature patient billing? Trying to cut our 60+ AR without dinging patient satisfaction.
, we saw the same 18% spike on BCBS/Aetna after 1/2 even with Availity showing primary active. > the first 277CA pend or waiting for a second request to avoid premature patient — we auto-send a 2‑question SMS at the first 277CA and hold the claim 7 days; if no response and a second 277 pends, we call and only bill after that or a patient‑confirmed secondary. For Aetna, updating COB in Availity before resubmission and adding NTE ‘COB verified [date]’ shaved about a week off our 60+.
But we only trigger a 2‑question patient COB text when the remit/271 flags “other coverage exists” and we batch-refresh files nightly via CAQH COB Smart (CAQH Coordination of Benefits), which dropped our BCBS/Aetna COB returns about 10%. Aetna’s feed lags, so we wait 3–4 business days before pinging the patient to avoid false alarms — like checking the fridge before ordering takeout.
We switched to a 12‑day COB hold: suppress statements, run a nightly 270/271 refresh, and push a COB update in Availity for the Blues and Aetna; only if it’s still stuck on day 12 do we send a tiny “not a bill” text. @vicmart your batching note tracks, and this shaved about 8% off 60+ without extra calls — belt‑and‑suspenders, but it works. Do you have a nightly 270 sweep or wait for the second pend?
I file the Aetna COB dispute at first 277CA since 1/2; hold statements 10 days — https://www.aetna.com/health-care-professionals/forms/coordination-benefits.html.