Coordination of benefits (COB) errors can be a major pain point for providers, leading to costly denials and significant delays in payment. When multiple insurance plans are involved, determining which insurer is responsible for payment first is crucial. Failing to get this right leads to missed revenue, disrupted cash flow, and administrative headaches for billing teams. Below are the key pain points health systems face when COB is not managed properly:
Pain Points of COB-Related Denials:
- Denied Claims: Billing the wrong payer results in immediate denials and potential lost revenue.
- Resubmission Delays: Manually correcting and resubmitting claims wastes valuable time, dragging out the payment process.
- Cash Flow Interruptions: Long delays in reimbursement slow down your organization’s revenue cycle, putting financial stability at risk.
- Administrative Burden: Manually managing COB processes adds unnecessary work to your billing staff, increasing the likelihood of human error.
With these pain points in mind, here are the top five best practices your billing team can adopt to minimize COB errors and protect your bottom line.
1. Verify Coverage at Every Encounter Using Real-Time Eligibility Checks
COB-related denials often stem from outdated or incorrect insurance information. Patients’ coverage changes frequently—whether through job transitions, Medicare eligibility, or updates to their plan. It’s crucial to verify insurance details at every encounter. Pair this with real-time eligibility checks to automatically identify which payer is primary and avoid billing mistakes.
Best Practice: Implement technology that verifies insurance coverage in real time at the point of registration, ensuring you have the correct payer information upfront.
2. Leverage Data Analytics to Identify Coordination of Benefits Trends
Tracking trends in COB-related denials can reveal inefficiencies in your processes. By analyzing which types of patients or payers cause the most COB errors, your team can proactively improve workflows and reduce future denials.
Best Practice: Use data analytics to identify common COB issues and adjust billing protocols accordingly. This helps your team anticipate and prevent errors before claims are submitted.
3. Establish Clear Internal Protocols for Handling COB Discrepancies
Because each insurance company has different rules for coordinating benefits, discrepancies in COB can occur frequently. Establishing clear, standardized internal protocols helps your billing team follow consistent steps when these issues arise, reducing confusion and mistakes.
Best Practice: Create and train staff on standardized COB handling protocols that outline clear steps for resolving discrepancies. This ensures consistency and reduces costly errors.
4. Regularly Train Billing Staff and Conduct Audits
Keeping your billing staff up-to-date on the latest COB rules and payer-specific regulations is critical. Regular training and audits ensure your team is well-prepared to handle complex COB cases and stay compliant with evolving payer guidelines.
Best Practice: Invest in ongoing COB education and conduct routine audits to identify potential areas for improvement. Well-trained staff are better equipped to avoid common COB pitfalls.
5. Automate Coordination of Benefits with Insurance Discovery Technology
One of the most effective ways to streamline COB management is by automating the process. maxRTE Insurance Discovery leverages nearly 30 years of industry experience and a deep understanding of complex payer rules to automate COB and determine insurance primacy when multiple coverages are active. Powered by AI and advanced algorithms, maxRTE handles COB at the front end of the revenue cycle, ensuring claims are submitted to the correct payer the first time.
This automation not only reduces the administrative burden on your billing team but also accelerates cash flow and minimizes the risk of human error. By removing the need for manual COB coordination, maxRTE enables your team to focus on higher-value tasks while preventing costly denials.
Best Practice: Integrate a solution like maxRTE Insurance Discovery to automate COB, increase accuracy, and speed up reimbursements—saving both time and money.
Conclusion: Take Control of COB to Protect Your Revenue
The cost of COB-related denials is too high to ignore. Implementing best practices like real-time eligibility checks, data-driven insights, clear protocols, and regular staff training can dramatically reduce errors and keep your revenue cycle running smoothly. Automating the COB process with maxRTE Insurance Discovery allows you to eliminate manual mistakes, accelerate cash flow, and reduce the administrative burden on your billing team—setting your organization up for long-term success.