Coordination of Benefits for Federal Agencies
Those who receive healthcare coverage through various federal agencies may also have coverage from other health insurance (OHI), either through an employer, a spouse’s employer, or other means. In such cases, that insurer is primarily liable for the individual’s healthcare claims.
Making sure that the agencies do not pay claims that should be covered by OHI ensures more money remains in the system to allow better care for all members.
Coordination of Benefits (COB), or Insurance Identification and Verification (IIV) is the process used to identify and bill the responsible payer. To date, HMS has identified and verified more than 2.5 million billable insurance policies.
For more than a decade, HMS has provided this service to military health agencies, the Veterans Health Administration (VHA) and the Defense Health Agency (DHA). Our proactive approach avoids costs before ineligible claims are paid, and also recovers funds that were incorrectly paid to the wrong insurer.
As a result of our services, customers save a bundle every year.
Our industry expertise and ability to integrate HMS best practices with the uniqueness of federal systems and requirements has created the most accurate and productive solution available. We leverage enormous amounts of proprietary data and verification and data matching techniques to enable federal health programs to identify and pursue third party sources for payments of current and future healthcare claims.
When we identify issues, we can bill claims to the liable third party, recover funds, track outstanding debts, and manage the collection process, allowing federal healthcare programs to reduce administrative red tape and costs.
How can HMS go to work for you? Fill out the Contact form today to connect.