Duplicate Coverage Questions
Other Party Liability
There is a lot about health insurance that can be confusing. One of the most frequent questions we get at Blue Cross and Blue Shield of Kansas is about other party liability. People often don't understand why we go to such great lengths to be sure we do not pay out funds for services that are covered under another insurance policy.
As a cost containment measure, Blue Cross and Blue Shield of Kansas health contracts contain a non-duplication of benefits provision. The provision ensures that our customers do not receive duplicate payments for the same claim through multiple health insurance policies or carriers; payment between the two (or more) carriers may not exceed the total charge of the claim.
Also found (in most BCBSKS contracts) are exclusions which deny benefits for services eligible under a workers' compensation law or no-fault auto insurance. This places the responsibility for these types of expenses with the proper carriers.
These cost containment features are called other party liability. They lessen the amount of money the insurance company pays and helps keep rates lower for our customers. Through the other party liability process, our customers save millions of dollars each year.
If you, your spouse or your covered dependent children are enrolled in other health insurance, please complete the Duplicate Coverage Questions form and return to us. This will help us coordinate benefits with other insurance carriers and save money for our members. You can fill out and submit the electronic form by logging in to BlueAccess® and clicking on "Duplicate Coverage Questions" in the lower right menu. Or you may print and mail or fax this form to us.
If you have any questions regarding duplicate or other party liability, contact us at 1-800-430-1274. We will be happy to assist you.
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