FWA Insights: Identifying adult day health billing schemes
Learn how Cotiviti’s investigators identified outlier providers in Adult Day Health (ADH) billing, what their analysis uncovered, and how health plans can strengthen oversight.
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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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Risk Adjustment Essentials%%Sign up for our ongoing webinar series throughout 2026
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HEDIS MY 2027 Public Comment: What to know
Learn the key elements of NCQA's proposed changes for HEDIS Measurement Year (MY) 2027.
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Webinar: CMS Final Rule%%Register for our next Quality Decoded webinar on 4/23
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Improving medical record retrieval: 5 best practices
Learn how to enhance retrieval success, improve outcomes, and foster collaboration—without increasing provider burden or placing strain on internal teams.
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FWA Insights: The top fraud schemes of 2025
Mitigate FWA risks in 2026 with these lessons learned from 2025 in lab testing, home health and hospice, and telehealth.
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2027 CMS Advance Notice: 4 key updates
Understanding the 2027 CMS Advance Notice is crucial for optimizing plan performance, ensuring compliance, and maintaining a competitive edge.
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Get 2026 risk adjustment coding insights%%Watch our on-demand webinar
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FWA Insights: Preventing overbilling in therapeutic home services
Learn how prospective analytics and expert review uncovered home health billing errors.
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3 key payment integrity trends to watch in 2026
As 2026 gets underway, here are three key shifts for payment integrity and compliance teams to monitor.
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Star Ratings reset: How MA plans can prepare
Learn the most impactful changes proposed in November 2025 to the CMS Star Ratings program and how to pivot for success in 2026.
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Everest Group names Cotiviti the highest-designated Leader in Payment Integrity%%Read the Payment Integrity Solutions PEAK Matrix® Assessment 2025
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FWA Insights: Billing for services not rendered
Learn key red flags to look for in healthcare fraud schemes involving services not rendered and how Cotiviti helped identify a multimillion-dollar scheme.
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Payment Integrity Pulse%%Watch our full 2025 webinar series on demand
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Navigating the 2026 ICD-10-CM coding updates
Review key ICD-10-CM updates and adopt best practices to prepare, adjust, and thrive in the new year.
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Talk with an expert %% Learn more about how our solutions can help you meet your goals
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Podcast: An innovation roadmap for risk adjustment strategies
Senior leaders from Cotiviti and Edifecs offer strategies for building scalable risk adjustment technology initiatives while navigating rising business and regulatory pressures.
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Achieving Star Ratings success in the ECDS era
Learn how to maintain or even boost your Star Ratings as hybrid measures are retired and digital quality becomes the norm.
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The practical landscape of AI in payment integrity and VBP
Learn how artificial intelligence can be deployed practically to improve payment integrity and value-based payment operations.
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Closing the Gap%%Improve care gap closure through targeted quality improvement and member engagement
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FWA Insights: Stopping “phantom providers” with prepay intervention
Learn how phantom provider schemes work and how to stop them with prepay fraud, waste, and abuse interventions.
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Evolving healthcare FWA management in 2026 and beyond
Learn how payers can deploy technological advancements and machine learning alongside human expertise to reduce FWA.
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2026 Star Ratings: What they mean and what comes next
Review the 2026 Star Ratings results, examine key measures and cut point impacts, and learn practical recommendations for boosting Star Ratings performance.
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Protecting employees' healthcare dollars
Learn how self-insured employers can safeguard their employees' healthcare premiums with robust payment integrity programs.
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Avoid payment errors and increase savings with these resources
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Decoding the 2026 Star Ratings
Join Cotiviti as we break down the 2026 Star Ratings results and offer practical recommendations to help improve your performance and member outcomes in the future.
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FWA Insights: Appropriate billing of intensive outpatient programs
Learn how to spot red flags in billing for intensive outpatient programs (IOPs) with these insights from Cotiviti's FWA team.
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Preparing for 2026: Adapting to new risk adjustment regulations
Learn the impact of the latest changes in risk adjustment for 2026 and beyond.
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