Cotiviti Blog

Checklist: How to build a valuable coordination of benefits program

Written by Evan Okulanis | Aug 1, 2024 2:42:38 PM

Payers face rising costs, increased post-pandemic demand, and growing expenses, leading to unfavorable medical loss ratios (MLR). A robust coordination of benefits (COB) program can significantly reduce these costs, improve member relations, and prevent provider issues. However, many payment integrity programs lack the necessary bandwidth, advanced data analytics, and strong business rules to effectively coordinate benefit payments.

Health plans need a comprehensive, member-focused COB program that includes continuous monitoring, accurate data, and auditing expertise. To help you implement an effective COB program, we have created a checklist that outlines essential steps for success.

Our checklist will guide you through key strategies to enhance your COB efforts, such as:

  • Enriching your data
  • Focusing on the claims most likely to yield a finding
  • Understanding the lifecycle of your members
  • Embracing human expertise
  • Verifying employment status thoughtfully

Don't miss an opportunity to make your COB program more efficient and precise , ensuring smoother benefit coordination and accurate payments.