If you have more than one health insurance plan, your benefits must be coordinated to determine which plan pays first. This process is called Coordination of Benefits (COB).
How the Claims Process Works
If Sana Is Your Primary Insurance
Nothing changes. Sana will process your claims as usual according to your plan benefits.
If Sana Is Your Secondary Insurance
If another insurance plan is determined to be primary, that plan must process the claim first.
In this case:
- The primary insurance processes the claim.
- An Explanation of Benefits (EOB) is issued by the primary insurance.
- The primary Explanation of Benefits (EOB) must be submitted to Sana before Sana can process the claim as secondary.
If a primary EOB is not received, the claim will be denied until that information is provided.
Who Submits the Primary EOB?
The provider or you, the member, can submit the primary EOB.
If your provider does not automatically send the primary EOB to Sana, you may need to request a copy from your primary insurance and submit it to us directly.
What Happens After COB Information Is Submitted?
Once we receive the necessary information (such as a completed COB questionnaire or a primary EOB), we will:
- Review your coverage details
- Determine which plan is primary and which is secondary
- Process claims accordingly
Our Support team will notify you once the review is complete and let you know what to expect next.
Prior Authorization When Sana Is Secondary
If Sana is secondary and the primary insurance approved the service:
- Sana does not require separate prior authorization.
- Sana will honor the primary payer’s approval.
However, Sana will not pay for services that are not covered under your Sana plan, even if the primary insurance approved them.
Why a Claim May Be Delayed or Denied
If you see a claim that has not processed, it may be because:
- A COB questionnaire needs to be completed, or
- A primary EOB is required.
Claims cannot be processed until we confirm which insurance is primary and receive the necessary documentation.
What You Should Do
If you are notified about a Coordination of Benefits issue:
- Complete the requested COB questionnaire promptly.
- Contact your primary insurance to obtain the EOB if needed.
- Submit the EOB to Sana as soon as possible.
Taking these steps quickly will help avoid delays in processing your claim.
Need Help?
If you’re unsure whether Sana is primary or secondary, or you’re not sure how to get your primary EOB, contact Sana Support. We’re happy to help guide you through the process.
Have questions? We've got you covered.
- Log in to view account details.
- Search FAQs in our Help Center.
- Connect with Customer Support directly through the chat icon on most Sana pages or call us at (833) 726-2123 Monday through Friday, 7 AM to 7 PM Central.