Proactive COB

Improve COB accuracy before claims are submitted

Move coordination of benefits (COB) upstream, verifying member coverage at enrollment and throughout the member lifecycle

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Proactive COB benefits

Prevent avoidable COB spend upstream

20–30%

of COB errors prevented upstream before claims generate*

>40%

reduction in retrospective COB recovery volume*

*Based on internal projections. Results may vary depending on factors including but not limited to usage and application.

Verify coverage and primacy at enrollment

COB recovery can be costly, abrasive, and often occurs after payment errors have already been introduced. Proactive COB helps shift COB validation earlier in the process by identifying and validating member coverage and primacy—both at enrollment and continuously as coverage changes. Using AI-powered member matching, continuous eligibility monitoring, and CMS data integration, the solution helps to identify other coverage as it changes and supports more accurate member records before claims are submitted. The result helps reduce downstream recovery burden and improve payment accuracy.

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>30%

client savings in 2025

Discover the value of Proactive COB

Shift COB from retrospective recovery to real-time prevention with a solution designed to complete the full COB lifecycle.

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Prevent avoidable medical spend

Identify other coverage before claims occur, helping reduce improper primary payments and improve medical loss ratio performance.

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Improve data accuracy

Use Cotiviti’s validated member data, identity resolution, and automated updates to help maintain cleaner eligibility records.

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Reduce administrative waste

Move work upstream to help minimize recoupments, appeals, manual updates, and improper member outreach tied to incorrect COB data.

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Lower provider and member abrasion

Prevent downstream takebacks, confusing benefit reversals, and unrecoverable denials by confirming the correct payer before service.

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COB expertise

Count on Cotiviti for end-to-end COB performance

Proactive COB is one component of Cotiviti's end-to-end COB approach, complementing prepay and postpay solutions as part of Cotiviti’s broader Payment Accuracy portfolio and structural utility layer connecting payers and providers.

With >25 years of specialized COB expertise, validated member data assets, automation, and AI-driven prioritization, Cotiviti helps plans intervene earlier, sustain accurate determinations, and improve COB program performance.

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