Features and benefits
Cost avoidance over pay-and-chase
We combine pre-pay and post-pay identification, investigation and recovery efforts to support a complete membership integrity service. We detect other policies with current national eligibility information and our database of more than 110 million lives.
We also work with strategic partners that offer health care and non-health care data sources. By refreshing data on a weekly basis, we reduce abrasion of denials caused by outdated information.
Our rigorous, timely data validation process helps avoid costs and improve savings.
What makes our Coordination of Benefits unique?
We have broader access to data that allows early identification of primary payer. By continually updating data, claims can adjudicate promptly rather than waiting for primary verification.
When post-payment recovery is required, we have strong relationships with providers and other carriers to recoup dollars.
Coordination of Benefits results
For 1 million lives, we average 3.2 million policy matches, $430 million in savings, and 87% cost avoidance versus pay and chase.