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API

Real Coordination of Benefits Intelligence

Lowers payer costs via instant coverage checks

Our API empowers payers with real‑time coordination‑of‑benefits insights, reducing administrative burden and improving claim accuracy from the start. By automating eligibility checks and detecting other coverage instantly, it minimizes rework, lowers costs, and accelerates payment cycles. Payers gain greater efficiency, cleaner claims, and a smoother member experience.

Identify and validate primary coverage

This API uses a comprehensive dataset of eligibility records from multiple health plans, supporting more accurate and efficient claims processing. Our solution helps determine the order of coverage, reducing information gaps that can lead to billing errors, eligibility denials, and recovery cycle inefficiencies.

Help prevent denials due to COB errors

By identifying the correct primary payer before claim submission, our solution helps reduce eligibility errors, alleviate administrative rework associated with claims processing, and minimize unnecessary overpayments and rebilling processes.

Help lower costs, and accelerate payment cycles

Our real-time capabilities reduce costs caused by COB errors, hence increasing efficiency.

Developer Resources

Real Coordination of Benefits Intelligence API

API Documentation
Frequently Asked Questions

Q: Do you have a sandbox that I test before signing a contract?

A: COMING SOON -- Yes! We encourage you to use our sandbox environment before signing a contract. The login requires a separate set of credentials that you can get from your Starter Guide. After receiving your client_id and client_secret for our sandbox environment, you can test the API in our interactive documentation, an application like Postman, or test the APIs using your own development console before making any commitments.

Q: What are the key benefits of Real coordination of benefits intelligence for payers?

A: The key benefits for payers is to determine the order of coverage, reducing information gaps that can lead to billing errors, eligibility denials, and recovery cycle inefficiencies. 

Q: How does the eligibility check process work in real-time, and what data sources are utilized?

A: The eligibility check process uses an API call to a member data store based on the current technology that will be used.

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Application Programming Interface

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