Coordination of Benefits
With approximately 1% of medical spend and millions of dollars of overpayment associated with COB, technology and automation can have a positive impact on your internal audit team’s efficiency and COB overpayment findings. A Payers internal COB team spends a lot of time on administrative and manual processes. With an integrated platform and automation, your team can turbo charge internal COB findings and move more to Cost Avoidance
AuditShark|COB is a Coordination of benefits platform purpose built to help Payers automate the process of finding members with other insurance coverage. AuditShark|COB eliminates the need for managing source files like State TPL, CAQH COB Smart etc., manually identifying Members, manually assigning work, logging into other insurance websites, and identifying potential overpaid claims. AuditShark|COB can bring together all your files including your back sweep/Members with enrollment changes, state TPL, CobSmart (CAQH), MSP Section 111 files, identify the members with potential other insurance coverage, programmatically capture other payer coverage information (from their websites and IVR lines) and identify the Members with overpaid claims and changes in coverage and present them to your team for review.