Streamlining Coordination of Benefits for Members with Secondary Coverage

October 25, 2021

Blue Cross and Blue Shield of Texas (BCBSTX) is working with the Council for Affordable Quality Healthcare (CAQH) to help identify some commercial members who have more than one health insurance policy. By leveraging CAQH’s COB Smart® database, we are collaborating with other health insurers to streamline benefit coordination.

Background: Historically, coordinating payments for members who have multiple policies has been a lengthy, manual process. This challenge has been costly for everyone across the health care industry. Tracking down multiple policies for members resulted in delayed and inaccurate payments, stakeholder abrasion, significant recovery activities and unnecessary administrative costs.

How it works: CAQH is a non-profit alliance of health plans and trade associations that creates shared industry initiatives to streamline the business of health care. Its COB Smart database contains records for approximately 180 million insured members, over half of the insured population in the U.S. We will use the database to identify members with overlaps in health coverage and facilitate more efficient claim adjudication.

Benefit: By collaborating with CAQH, BCBSTX is working to reduce administrative burdens and timelines required to coordinate these claims, resulting in faster and more accurate claims payments to you.

References to other third-party sources or organizations, such as CAQH, are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly.