Regional plan exceeds expectations with second-pass COB

Coordination of benefits (COB) is an intricate, time-consuming process for all health plans—sifting through data assets, checking validity, establishing primacy, and more. But having a seasoned partner to cut through complexities for speed, accuracy, and detail can mean significant savings. 

That’s why a regional health plan enlisted the help of Cotiviti’s retrospective COB Validation solution and started seeing results fast. Initially using Cotiviti’s prepay Payment Policy Management and Coding Validation solutions, the plan deployed COB Validation in 2024 for commercial and Medicaid lines of business as a second-pass review to find what a first pass might have missed, including more complex issues.

After implementation, Cotiviti quickly identified findings more than three times initial estimates. Within a month of receiving initial COB Validation data, the client had already realized savings above $650,000.

The plan has achieved an average 90% yield rate, with certain months reaching as high as 98%. The program continues to exceed expectations, with $2.5 million savings year to date and a full-year forecast of $3.7 million. 

Key results*

>$650K COB savings in the first two months

90% average yield rate, with some months reaching 98%

>200% findings in excess of initial estimates

Key benefits

• Reaped benefits of deeper, second-pass findings

• Realized high savings immediately after implementation

• Gained high-quality findings that nearly all convert to savings

Key Cotiviti differentiators

• $805M saved by our COB Validation clients in 2024, including specialty drugs covered under medical benefits

• Trusted partner of choice with >20 years of proven success

• 30% additional medical cost savings beyond internal teams and vendors- 

*The results depicted are based on an individual client’s experiences and circumstances. Results may vary depending on factors including but not limited to usage and application.