Infographic: 4 CMS Reconciliation Pitfalls Costing Health Plans Time, Money, and Members
Medicare Advantage plans are under increasing pressure to reconcile CMS data with greater speed, precision, and audit-readiness—especially when it comes to Medicare Secondary Payer (MSP) and Coordination of Benefits (COB) files. As CMS reporting requirements grow more complex and enrollment dynamics shift, health plans must adapt quickly or risk compliance violations and financial shortfalls.
While most plans perform some level of MSP and COB reconciliation, many continue to rely on partially manual processes or outdated logic that no longer scales. The infographic below highlights four of the most common operational pitfalls we see in the field—from lagging data timelines to audit documentation gaps—along with modern, automated approaches that address them.
Whether you're reassessing your current process or building one from the ground up, understanding these challenges is the first step toward a more resilient reconciliation strategy.
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