Software
Coordination of Benefits Solutions
A solution for payers and TPAs who want to optimize cost savings with accurate eligibility information and proactive identification of undisclosed coverage prior to claim payment.
IdentifyCoverage Earlier
Achieve 99% accuracy in verifying alternative coverage.
Our nationwide eligibility data repository contains policy coverage across multiple policy types, driving unprecedented accuracy and savings for payers and TPAs.1
Improve provider satisfaction
Gain access to integrated medical, pharmacy, dental, and vision eligibility information updated daily.
Deliver accurate coverage data
Identify undisclosed coverage prior to claim payment to help reduce the cost and time spent on retrospective claim analysis and payment recovery.
Streamline recovery of improper payments
Take advantage of payer-initiated offsets and our reclamation program to streamline payment recoveries, even as you minimize your need for them.
Coordinate benefits for dual-eligible members
Maintain payment accuracy by automatically validating member statusÌýfor Dual Special Needs Plans, Medicare Advantage Plans, and other dual coverages.
Contain Costs Across the Payment Continuum
Providing Measurable Value
accurate verification of alternative coverage1
average PMPY increase in cost avoidance2
average increase in recovered payments2
1. µç³µÎÞÂë internal statistics based on data for all customers using the Coordination of Benefits solution during a one-year period. Individual results may vary.
2. Ibid.
Our outcomes
PRODUCT SUPPORT
Need support for
this solution?
- Coding Advisor Discover how our claims adjustment solution for payers helps identify billing outliers and reduce overpayments of low-dollar, high-volume claims. Learn more
- Audit & Recovery Discover our overpayment audit and recovery services for payers that want to maximize recovery, reduce improper payment waste, and promote provider satisfaction. Learn more
- Pre-Payment Insight & Review Learn how our prepayment medical record and claims review solution helps identify improper payments before they are paid and reduce waste in the payment process. Learn more
- Integrated Repricing Network Learn how our claims repricing solution accesses 50+ national & regional PPO networks through a single interface & uses routing optimization for maximum savings Learn more
Join Community discussions
Find and share knowledge, exchange ideas, and collaborate with peers and µç³µÎÞÂë experts to drive your solutions to success.