Coordination of benefits consensus solution
Clarify payment responsibility faster
Many members have coverage through more than one health plan. Knowing when your plan is — or isn’t — the primary plan responsible for a claim’s payment can help save valuable healthcare dollars and manage rising costs. Our coordination of benefits consensus solution helps determine which payer is responsible, resulting in faster, more accurate claim payments.
Lines of business
• Commercial
• Medicare
• Medicaid
• Federal employee
What happens when primary coverage is clear from the start?
Our solution helps expedite the identification of other coverage and streamline the process of determining the responsible primary payer.
Reduce administrative costs
We help you reduce calls, disputes, and rework for your plan and providers.
Create clarity in the payment workflow
Our solution helps deliver consistent, clear outcomes — the first time around. That way, the coordination of benefits process is more predictable and understandable.
Drive provider and member satisfaction
With faster, more accurate decisions, we help you create an improved provider and member experience .
Inside our coordination of benefits solution
Leave the guesswork out of coordination of benefits. Our solution brings together powerful technologies and real-world expertise to help you identify and resolve questions about primary coverage accurately and efficiently.
Highly secure data platform
Industry-wide eligibility data channels
Analytics platform
Online workflow collaboration tool
Dashboards and reporting
Highly secure data platform
Industry-wide eligibility data channels
Analytics platform
Online workflow collaboration tool
Dashboards and reporting
How our solution works
Collect
We collect and store your membership and other health plan leads on a highly secure platform.
Analyze
We leverage our comprehensive primacy rules engine and curated eligibility information to consistently, accurately, and automatically identify the responsible primary payer.
Enhance
We provide validated supporting documentation offering transparency into accurate, consistent primacy decisions.
Explore related solutions
Ask us about our coordination of benefits solution
Health plan leaders, contact us to learn more about the possibilities and impact of our coordination of benefits solution.
Are you a health plan member?
If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.
