Introducing Cotiviti's 360 Pattern Review
Learn how Cotiviti's 360 Pattern Review offers comprehensive FWA prevention and management across the entire claim payment cycle, seamlessly integrating with your existing programs and personnel.
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Our latest healthcare payer resources
Improve your payment, risk, quality, and member engagement outcomes with the latest healthcare insights from Cotiviti's leading experts including customer case studies, webinars, white papers, and articles.
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Webinar: Advance beyond traditional FWA lead detection%%Join us Thursday 12/12
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The fundamentals of payment integrity for TPAs
Learn crucial strategies for TPAs to deliver effective payment integrity programs for their self-funded clients.
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CMS Star Ratings: A guide to quality improvement
Read this guide as we break down the CMS Star Ratings, recent changes to the program, and strategies to drive better outcomes.
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Podcast: Driving lasting impact through interoperability
As TEFCA continues to evolve, Cotiviti joins the RISE Radio podcast to discuss key interoperability updates and strategies for 2025.
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Visit our YouTube channel%%Subscribe for our latest webinars and more
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Counteracting FWA in dental payments
Learn about common inappropriate dental billing practices and how dental payers can target them through automated solutions and clinical review.
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Cotiviti named 2024 Best in KLAS® for payer quality measurement and reporting
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Busted: The top fraud schemes of Q3 2024
Physician fraud, genetic testing fraud, and fraudulent DME billing made up some of the most notable FWA cases in the third quarter of 2024.
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Enabling a high-quality and viable healthcare system
With a steadfast commitment to providing total value, Cotiviti stands out as a strategic partner for health plans aiming to optimize their operations.
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Prepay claims editing delivers millions in value for self-funded employers
Learn how Cotiviti helped one benefit administrator deliver $28M in medical cost savings to clients.
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Case study: Engaging members to apply for the Low-Income Subsidy (LIS)
Learn how one large Medicare Advantage plan successfully helped its members retain critical low-income benefits.
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3 takeaways for Medicare Advantage plans from the 2025 Star Ratings
As Medicare Advantage plans continue to see their Star Ratings decline, here are three takeaways from the newly released 2025 Star Ratings.
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Talk with an expert %% Learn more about how our solutions can help you meet your goals
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Decoding the 2025 Star Ratings
Watch our webinar to understand the major takeaways from this year’s ratings and how they impact Medicare Advantage plans.
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Highmark Wholecare prevents FWA with Claim Pattern Review
Learn how Highmark Wholecare prevented improper payments and FWA with Cotiviti's prepayment integrity solution.
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Coding deep dive: Best practices to improve accuracy
Watch our deep dive into 2024 risk adjustment coding updates, anticipated impact, and long-term trends
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Closing the Gap%%Improve care gap closure through targeted quality improvement and member engagement
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Proactive member engagement strategies to close gaps in Medicare Advantage
Learn tips to prepare for the Annual Election Period and upcoming CMS changes.
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Program Integrity Pulse: Lessons learned from a successful prepay FWA program
Learn Highmark Wholecare’s strategy for preventing improper claims while seamlessly referring verified fraud leads to the SIU.
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Prepay integrity: What the self-insurance industry needs to know
Learn how TPAs can deliver a high-performing payment integrity program to their plan sponsor clients—and why it matters more than ever.
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Decoding the HEDIS MY 2025 Technical Specifications
Learn what health plans need to know for HEDIS Measurement Year (MY) 2025, including measure retirements, new measures, and changes to existing measures.
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Avoid payment errors and increase savings with these resources
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Partnering for success in 3 critical areas of risk adjustment
Discover best practices to improve your risk adjustment program and strengthen results and compliance.
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Recovering improper costs in SNF and IRF claims
Learn how to untangle the complexity of skilled nursing facility (SNF) and impatient rehab facility (IRF) claims.
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Engaging with members at the end of the year
Watch our webinar as we discuss how proactive, multi-channel approaches to member engagement can significantly improve gap closure, member satisfaction, and plan growth.
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