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Coordination of Benefits

Identify and validate primary policy coverage.


Proactively identify additional sources of coverage

Coordinating benefits can be a complex and costly undertaking. Learn how Optum Comprehensive Coordination of Benefits uses an end-to-end approach to identify and validate primary policy coverage, saving health plans an estimated $11–$18 PMPY.

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Maximize savings with cost avoidance

Cost Avoidance Coordination of Benefits combines machine learning models with our best-in-class data lake to identify COB at member enrollment. Potential policy matches are validated by Optum subject matter experts, and clients are notified when other primary coverage is confirmed. This enables health plans to maximize savings and minimize provider and member abrasion.

Unparalleled eligibility data

With eligibility records across medical, dental, vision and pharmacy policies, our data lake is the most comprehensive in the COB industry. Data is refreshed daily enabling Optum to identify members who have other primary coverage with efficiency and more than 99% accuracy. This enables health plans to immediately update their eligibility systems and prevent future overpayments.

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Add Coordination of Benefits to your payment integrity portfolio today.