The Biggest Mistake Health Plans Make in CMS MSP & COB Management
By Julie Kendall Hughes, Chief Compliance and Consultancy Officer
Processing CMS Medicare Secondary Payer (MSP) and Coordination of Benefits (COB) data isn’t just a compliance checkbox—it’s one of the most operationally complex areas of health plan administration. Yet many health plans underestimate the true scope and impact of MSP and COB management, and that’s where costly mistakes begin.
In a new video, Imagenet Chief Compliance and Consultancy Officer Julie Kendall Hughes shares more about why and how effective MSP and COB handling means navigating:
Multiple data sources from CMS and other entities, each with unique formats and rules.
High volumes of constantly changing information that require rapid updates to keep member records accurate.
Integrated operational processes to ensure data isn’t just stored—it’s actively used to guide decisions and avoid downstream errors.
In this new video, learn more:
Learning the Risks Is Essential
When health plans view MSP and COB management as only a documentation requirement—rather than a core operational function—they expose themselves to serious risks. These risks include:
Operational breakdowns that slow claims processing and disrupt provider relationships. Provider abrasion is an ongoing challenge for health plans, and can result in increased workloads, unhappy providers, and damaged trust. The problems usually surround payment delays, claim denials, and burdensome administrative processes.
Negative audit findings from CMS due to incomplete or inaccurate data handling.
Poor member experiences caused by billing errors, coverage confusion, or payment delays. New McKinsey & Company research finds that improving the member experience relies on a streamlined “end-to-end healthcare journey,” one which prioritizes “benefit education, payment, and access to care and medication.
How to Improve MSP and COB Data Accuracy and Compliance
The reality is that MSP and COB data touches every part of the member lifecycle. Handling the member lifecycle effectively requires payers to have a superior balance of people, processes, and technology. Integrated technology–systems that can match, validate, and update data in real time, thus reducing manual work and errors–are crucial. It’s also pivotal to foster internal and external partnerships to bring together eligibility, claims, and enrollment data to create a single, accurate record. Finally, never underestimate the power of personnel. Teams that understand both complicated regulatory requirements and your operational workflows (or, where those workflows can be optimized), are essential for health plans—and, by extension, your members.
The bottom line for health plans’ bottom line? Compliance is only the starting point. The health plans that excel at MSP and COB management treat it as a strategic function—one that protects revenue, improves member satisfaction, and reduces audit exposure.
Our intelligent solutions include:
Digital Mailroom – Transform unstructured content into clean, actionable data—fast.
Claims Adjudication – Accelerate accuracy and compliance from intake through reconciliation.
Member Communications & Reconciliation – Ensure timely, accurate, and compliant member interactions.
Contact Center – Fully integrated, tech-driven support that improves experience and efficiency.