Medicare Secondary Payer (MSP) & Coordination of Benefits (COB)

Medicare Advantage premiums decrease approximately 80% when a member has secondary coverage. Health plans that are unable to accurately identify members with secondary payers often incorrectly pay claims as if they were the primary insurer. When health plans receive lower premiums and pay the full expenses, they can lose a lot of money.

Dynamic helps health plans by providing easy-to-use Medicare Secondary Payer (MSP) and Coordination of Benefits (COB) Solutions which:

  • Store critical MSP and COB information at a member level, including imported CMS files
  • Send and receive updates manually or through batch file submissions to the COB Contractor (Electronic Correspondence Referral System (ECRS))
  • Enable centralized source of COB primary and supplemental data to assist in True Out-of-Pocket (TrOOP) management and recovery research

Dynamic’s Solution Can Help You With

Revenue Optimization

Dynamic’s MSP / COB solution helps health plans optimize revenue by:

  • Automatically importing members with information relating to their secondary payers, which simplifies the identification of reimbursement opportunities from secondary payers and mitigate potential revenue shortfalls
  • Automatically submitting MSP/COB edits to ECRS, which reduces manual labor and increases acceptance rates
  • Coordinating TrOOP calculation, which can ensure that health plan premiums collections are accurate and timely

Compliance

Dynamic’s MSP / COB solution helps health plans maintain compliance with applicable regulations by:

  • Facilitating coordination of benefits with other carriers
  • Providing full visibility of all transactions through a compressive audit trail

Operational Efficiency

Dynamic’s MSP / COB solution helps health plans achieve operational efficiency through:

  • Automation that reduces health plans’ manual labor and operational costs
  • Automation that generates CMS required correspondence and stores all correspondence on the member records
  • Automation that ensures proper primary or secondary payment and recovery of overpayments
  • Requesting changes to existing other health insurance records and adding new other health insurance records

Schedule a complimentary demonstration to see how we can ease your correspondence burden!