COB Smart® for Pharmacy extends all the features you enjoy with COB Smart for your medical membership to your pharmacy membership. It will help you identify primary and secondary coverage and determine primacy weekly, before claims are paid, to increase payment accuracy and reduce administrative costs associated with recovery.
How will coordination of benefits (COB) impact the future of healthcare delivery? More states are expanding Medicaid, the ACA is evolving, and member experiences are more critical than ever to your health plan. With changes swirling in the healthcare ecosystem and many competing priorities for your organization, how will your COB processes advance?
For Medicaid/MCO payers, quick and secure access to reliable, accurate health plan data continues to be an ongoing challenge.
Please join us for a webinar featuring Laura Carraway, Director of Operations at Anthem to learn how her plan has achieved a 3-5% increase in cost avoidance by using COB Smart for their Medicaid line of business.
CAQH will be exhibiting at NOPLG. Stop by by the booth to learn how your health plan can better facilitate the coordination of benefits process with COB Smart.
Challenges related to coordination of benefits (COB) are a financial drain for health plans and a headache for providers. Claim payments are often made in error or delayed due to complicated manual processes, as well as a lack of clarity on which plan should be the primary payer.
How COB Smart® works
Participating health plans supply information to the COB Smart registry each week, where it is compared with data from other health plans to identify members with overlapping benefits. National Association of Insurance Commissioners’ (NAIC) rules are applied to determine the primacy of benefit coverage. This information is then shared with each participating health plan so it may be integrated into their existing workflows.
In late February, CAQH hosted COB Smart Connection: A Forum for Participating Organizations. The keynote speaker was Jolie H. Matthews, Senior Health and Life Policy Counsel at the National Association of Insurance Commissioners (NAIC). Created in 1871, the NAIC is a nationwide organization that establishes standards to improve the state regulation of insurance, including health and dental.
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