November 2, 2021
In October 2021, Blue Cross and Blue Shield of Illinois (BCBSIL) began 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’re 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, representing more than 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.
No Action Needed: You don’t need to do anything to benefit from this program. By collaborating with CAQH, BCBSIL is working to reduce the administrative burden and timelines required to coordinate these claims, resulting in faster and more accurate claims payments to you.
CAQH is an independent third party not-for-profit collaborative alliance of the nation’s leading health plans and networks. The mission of CAQH is to improve health care access and quality for patients and reduce administrative requirements for physicians and other health care providers and their office staffs. CAQH is solely responsible for its products and services, including the COB Smart database.
Information provided by BCBSIL is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider, nor is the information presented intended to replace or supersede any requirements set forth in your contract with BCBSIL. Any samples in this communication are for illustrative and/or educational purposes only and should not be relied on in determining how a specific provider will be reimbursed. In the event of a conflict between the information in this communication and your contract, your contract will control.