Case Study: Regional Insurer achieves $9M in missed recoveries with Conduent COB solutions

Regional Insurer recovers $9M with Conduent

A regional insurer was struggling to identify and validate members' other health insurance coverage, particularly for those aging into Medicare. This challenge left an estimated $5 million in annual recoveries unrealized because the insurer could not fully leverage its CAQH COB Smart data. The high-volume data stream required extra validation resources the plan lacked, causing it to miss opportunities for recoveries and future cost-avoidance savings.

Conduent implemented a customized solution to maximize the value of the insurer's CAQH membership. Their team validated a large portion of the undetermined and determined records, used proprietary data analytics to identify other coverage, and employed a low-touch engagement model to minimize member outreach. As a result, Conduent helped the regional insurer recover $9 million in previously missed recoveries since 2018 and an estimated $5 million in 2021 alone.

Regional Insurer