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Coordination of Benefits
CAQH leverages a continuously updated registry of coverage data on +200 million members to enable plans to coordinate benefits before claims are paid, reducing errors and increasing cost avoidance.
covered lives
validated identification of medical and pharmacy overlaps
national health plan participation
average increase in new secondary coverage identification

Lower Administrative Costs

After-the-fact coordination of benefits programs, commonly referred to as “pay and chase,” can be both expensive and ineffective. The CAQH COB solution reduces the costs associated with member canvassing for other coverage, claims denials, resubmissions and recovery. After implementing the CAQH COB solution, one national health plan achieved an 80:1 return on investment.


A regional healthcare provider and insurer in the northeast leveraged proactive COB data to reduce vendor spend by 70% and save $69M+ through cost avoidance and recovery efforts.

Inefficient coordination of benefits processes cost the US healthcare system more than $800 million annually. Too often health plans do not have access to timely information about overlapping coverage, and instead attempt to recover erroneous payments after a claim has been paid.

By taking a prospective approach to coordination of benefits, one of the nation's largest health plans was able to automate its internal processes and reduce spend on recovery vendors, saving $42M annually.



COB Smart meets key healthcare regulations and requirements for protecting and securing sensitive private healthcare information.

A Better Member Experience

Recovery vendors and programs send letters and call members to inquire about other health coverage.  This can be a nuisance to members, yields limited or incorrect information and is now unnecessary.  With advanced data matching and validating technologies, the CAQH COB solution provides plans with better information while eliminating the need for this inconvenience to members.



Get Ahead of It.

Coordination of benefits before claims are paid results in greater payment accuracy, a better member and provider experience, and more streamlined health plan operations