Cotiviti launches AI solution to address coordination of benefits issues for payers

Cotiviti launched Proactive COB, an AI-powered coordination of benefits solution, on August 13, 2026, to help healthcare payers and providers identify coverage errors at member enrollment. Traditional coordination of benefits processes are fragmented and prone to errors during life changes, leading to costly post-payment recovery. Currently in a pilot phase focusing on cost avoidance, Cotiviti plans to make the solution generally available in the first quarter of 2027.

Proactive COB AI solution launch

• ▪Cotiviti, a healthcare infrastructure company based in Salt Lake City, launched an AI-powered coordination of benefits solution called Proactive COB on August 13, 2026.
• ▪Cotiviti's Proactive COB solution is designed to support healthcare payers and providers at the time of member enrollment.
• ▪Cotiviti plans to make the Proactive COB solution generally available in the first quarter of 2027.

Coordination of benefits process challenges

• ▪Errors in coordination of benefits often occur when members change coverage due to life events like switching jobs, retiring, getting married, or having a baby.
• ▪Coordination of benefits determines how insurance companies cover medical expenses and which plan is the primary or secondary payer when a person has multiple health plans.
• ▪When people enroll in new coverage, health plans often receive incomplete or inaccurate coverage information, leading to undetected errors and costly post-payment recovery efforts.

Enrollment-based error detection approach

• ▪Cotiviti's Proactive COB identifies and validates other health insurance and determines the correct order of benefits using member enrollment data rather than waiting for a medical claim.
• ▪Matthew Herbein, vice president of product at Cotiviti, stated that Proactive COB is a claim-agnostic capability that identifies other health insurance at enrollment, which is earlier than typical industry practices.

Pilot performance metrics

• ▪Cotiviti is currently piloting the Proactive COB solution to test its integration and effectiveness.
• ▪During the pilot phase, Cotiviti is tracking success metrics including cost avoidance from reducing administrative waste, per-member-per-year impact, and integration smoothness.