We help you streamline benefits coordination
Health plans face many challenges when trying to identify and validate primary policy coverage, including:
- Time, staffing and budget constraints
- Lack of access to timely and credible eligibility records from other insurers
- High administrative costs associated with member attestations and staff validations
- Reliance on abrasive post-pay recovery and Medicaid reclamation rather than cost avoidance
But inaccurate coordination of benefits can be costly and often leads to higher administrative and medical costs as well as member and provider abrasion. Optum® Coordination of Benefits delivers accurate eligibility data to identify and validate primary coverage as soon as member enrollment.
Cost containment across the payment lifecycle
Coordination of Benefits helps health plans maximize savings at every stage in the payment lifecycle. With Cost Avoidance Coordination of Benefits, we coordinate benefits at member enrollment, reducing improper payments and time spent on rework and recovery.
Post-Pay Coordination of Benefits serves as a second line of defense, catching coordination issues that weren’t identified during the pre-pay process. This holistic approach ensures payment accuracy at a lower cost of ownership for our customers.
Unparalleled eligibility data for improved benefits coordination
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.
