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Cotiviti’s COB Validation solution delivers deep and broad coordination of benefits (COB) determinations, both prospectively and retrospectively. We provide thorough review and analysis of contracts, eligibility files, third-party benefits agreements, and other data sources to determine COB and payment responsibility. We target members with a high probability of Medicare coverage using custom analytics, validate eligibility with Medicare, and work with providers to re-file claims with Medicare. Our 20+ years of expertise in this specific area allows us to identify complex COB issues beyond any payment integrity vendors and programs that our clients may have in place. From this identification process, we build a store of comprehensive eligibility data and analytics that identify other commercial payer responsibilities.
- Go beyond existing payment integrity vendors and programs to identify complex COB issues
- Analyze more members and claim types, spanning across all medical products
- Identify members with a high probability of Medicare coverage or other commercial coverage using proprietary analytics
- Uncover high-value overpayment findings through a combination of analytics and subject matter expertise