Coordination of Benefits (COB)

CareSource has contracted with Health Management Systems (HMS) to identify CareSource members who have other insurance coverage and to make sure claims are paid by the appropriate primary carrier.

You may receive correspondence from HMS regarding coordination-of-benefit issues. Please remember that CareSource, as a Medicaid plan, is the payer of last resort after commercial health insurance carriers as well as Medicare.

We ask that you take measures to obtain third-party liability information from CareSource members. Please bill the appropriate carrier before billing CareSource.

Workers' compensation

All claims indicating that a Member's diagnosis was caused by the member's employment will not be paid. The provider will be advised to submit the charges to Bureau of Workers' and Unemployment Disability Compensation for reimbursement.

Automobile insurance

Under Michigan's "no fault" law, automobile insurance carriers are required to pay the medical expenses for injuries incurred in an automobile accident. However, in some instances, the automobile policy contains a rider stating that health insurance coverage takes priority over automobile insurance.

Providers may pursue "no fault" claims directly with the automobile insurance carrier. Providers may also bill CareSource while the automobile insurance claim is pending. CareSource must be billed within six months from the date the "no fault" claim was filed. CareSource then pursues reimbursement from the other insurance carrier through subrogation.

For more information, please see the Provider Manual.