Other Party Liability (OPL) Solutions
Identify other coverage, validate liability, prevent misattributed payments, and recover dollars when another party is financially responsible.
Support smarter payment decisions
When another health plan, carrier, employer, or liable third party is responsible for payment, missing or incomplete information can lead to avoidable costs and administrative effort. Carelon helps health plans identify payment responsibility earlier and take informed action by bringing together data, technology, investigation, recovery operations, and legal expertise.
Lines of business:
- Commercial
- Medicare
- Medicaid
- Federal employee
Audience:
- Payers
Explore our other party liability solutions
Find the right support for your program with solutions that help identify payment responsibility, strengthen recoveries, and manage complex liability needs.
Subrogation
SOLUTION
Full-Service Subrogation
Manage the end-to-end subrogation lifecycle from identification and investigation through stakeholder coordination, legal support, and recovery.
SOLUTION
Subrogation Overflow
Add scalable subrogation support that expands your team’s capacity, adds specialized expertise, and helps strengthen recovery performance.
SOLUTION
Subrogation Case Identification
Use data, analytics, and automation to identify potential subrogation cases, uncover recovery opportunities, and prioritize where to focus your efforts.
SOLUTION
Workers' Compensation Recovery
Navigate state-specific requirements and strengthen recovery performance with predictive analytics and experienced recovery specialists.
Coordination of benefits
SOLUTION
Coordination of Benefits
Identify other health coverage and determine the correct order of payment to help prevent avoidable overpayments.
Capture more value across the OPL lifecycle
A comprehensive other party liability approach does more than recover dollars after a payment is made. It creates opportunities to act earlier, make informed payment decisions, and efficiently recover payments when appropriate. Carelon helps health plans improve payment accuracy and recovery performance by connecting identification, validation, prevention, and recovery across the OPL lifecycle.
Identify coverage and liability earlier
Data integration, intelligent automation, and analytics help uncover other coverage, third-party liability, and recovery opportunities before avoidable costs grow.
Validate payment responsibility with confidence
Eligibility data, rules-based logic, investigation workflows, and stakeholder outreach help confirm payment responsibility and support defensible action.
Recover more while preventing future overpayments
Pursue appropriate recoveries, update records, and shift more value upstream by reducing repeat overpayments tied to incomplete coverage or liability information.
Ready to strengthen your other party liability performance?
Connect with us to see how a more connected OPL approach can help you identify payer responsibility earlier, take appropriate action, and improve program performance.