The tool will ensure that commercial coverage pays first when a Medicaid client also has commercial pharmacy coverage.
HMS, a vendor of the Department, will receive pharmacy claims on a daily basis and will search its eligibility database to see if there is other coverage.
If there is other coverage, HMS will submit the claim to the commercial PBM as if the claim came from the pharmacy.
If the claim is successfully adjudicated, an adjustment is sent to the Department in the form of a "re-bill" claim showing the amount paid by the commercial PBM.
Providers can search for activity or download transactions affected by COB Manager through a secured HMS web portal "eCenter."
You may contact HMS for access or for information regarding eCenter by calling 877-640-3419.
HMS staff will provide you the necessary information to log into the eCenter Web portal.
Please see the links below for further information regarding COB Manager.
