Coordination of benefits: What health plans are doing about it (podcast)


When patients have coverage from more than one health plan, their claims go through a “coordination of benefits” (COB) process that is fraught with complexity, expense and errors. CAQH, an alliance of health plans and trade associations, focuses on the development of tools to address issues like this one.

In this podcast interview CAQH’s Executive Director Robin Thomashauer and Project Director Atul Pathiyal discuss a new CAQH initiative to create a single source of coverage status that will make it easier for hospitals and physicians to bill insurers accurately when there are COB issues.

CAQH pegs the cost savings opportunity from better COB at about $800 million per year. Based on my experience with health plans I think it could be even more.

The health insurance world is changing significantly with the advent of the Affordable Care Act. No one –including CAQH– seems to know what impact Obamacare will have on COB.

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