Learn how to evaluate COB and patient involvement denial service partners to boost recovery rates, protect staff time, and improve patient satisfaction.
Coordination of Benefits (COB) and patient involvement denials may seem like relatively small issues across a healthcare provider's total revenue cycle challenges—but collectively, they can account for up to 2% of a hospital’s net patient revenue. These denials often remain unresolved because they frequently involve multiple payers, may necessitate manual follow-up, and can be surprisingly time-consuming at times.
Outsourcing COB denial management can help hospitals and health systems recover lost revenue and free up staff time—but only if you select the right partner.
The right partner brings not just technology and process efficiency, but also empathy, precision, and compliance rigor.
COB and Patient Involvement Denial Vendor Checklist
Here’s what to look for when evaluating a COB and patient information denial management service.
Specialized Expertise—Not Generic Denial Support
COB denials and patient involvement denials aren’t like other denial types. They require deep knowledge of payer coordination rules, patient communication, and claim resubmission nuances.
What to look for:
- 100% U.S.–based COB specialists trained in empathy, professionalism, and accurate documentation
- Proven experience navigating multi-payer claims and accident-related coverage issues
- Breadth of knowledge and access to systems to address VA, workers’ comp updates, and other payer nuances
An expert team can quickly distinguish which denials require payer outreach versus patient contact—and handle each with the professionalism your patients deserve.
Proven Data Security and Compliance
Your service partner will manage sensitive patient and financial information, so security and compliance standards must be non-negotiable.
What to look for:
- SOC 2 Certification for verified data protection controls
- Encryption (TLS 1.2) for all data in transit and at rest
- SFTP file transmission and centrally managed employee equipment
Strong security practices not only protect PHI but also demonstrate a service vendor’s operational maturity and reliability.
Process Automation and Seamless Integration
Efficiency is key. A strong vendor combines advanced automation with transparent workflows that complement your existing revenue cycle systems.
What to look for:
- Automated placements by CARC/RARC codes
- Automated closures by billing indicator or agency code
- Rebilling directly from your system to maintain accuracy and audit trail
- Automated adjustment files to streamline your reconciliation process
This level of automation reduces administrative friction and speeds up cash flow.
Data-Driven Best Practices for Account Selection
Not every COB denial is worth pursuing—but many are. The best service partners use experience-based thresholds and data analysis to focus on high-yield accounts.
What to look for:
- A defined best-practice placement strategy—such as placement at denial for accounts with balances over a data-backed threshold
- Performance metrics to track recovery rates and aging patterns
- A consultative approach to help your team refine internal processes
A partner that can articulate why and how they prioritize accounts demonstrates strategic maturity, not just transactional service.
A Patient-Centered Approach
Effective COB management goes beyond claims—it affects the patient experience. Confusing requests for insurance information can frustrate patients and erode trust.
What to look for:
- Specialists trained in empathy, professionalism, and clear communication
- Options for patient engagement, such as portal uploads, after-hours access, or guided three-way calls with the insurer
- Processes that minimize unnecessary patient involvement
A service partner that prioritizes patient understanding helps hospitals protect satisfaction scores and brand reputation while resolving denials faster.
Measurable Outcomes and Transparent Reporting
Before partnering, confirm the vendor can demonstrate quantifiable results.
What to look for:
- Documented recovery rate improvements for COB and patient information denials
- Faster time to resolution metrics
- Proven impact on cash flow and administrative savings
- Client references or case examples
A trustworthy partner should provide data that validates performance, not just promises.
The Bottom Line: Partner with a Vendor That Reflects Your Standards
A strong COB and patient involvement denial management partner should operate as a seamless extension of your revenue cycle team—secure, specialized, and patient-focused.
Hospitals partnering with the right vendor gain:
- Increased recovery rates
- Reduced administrative costs
- Improved cash flow
- Enhanced patient satisfaction
Knowtion Health’s U.S.–based, SOC 2-certified COB specialists deliver the expertise, security, and automation hospitals need to close revenue gaps and elevate the patient financial experience.
To learn how Knowtion Health can strengthen your COB and patient involvement denial recovery efforts, contact Services@KnowtionHealth.com.
