Health plans face a major challenge in acquiring valid and accurate enrollment data to coordinate benefits in a timely manner. The complexity of coordination of benefits (COB) makes overpayments more likely to occur when information gaps develop between plans, which can increase the burden on internal resources. The evidence for the effectiveness of retrospective review is strong—but recovering funds after payments are made is an intricate and tedious process. By combining retrospective COB with prepay review, plans can increase value by catching errors before claims are paid.

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