Read our Savings Spotlight and learn how one regional Blue Plan serving more than 4 million members achieved nearly $100 million in savings with Cotiviti's prospective payment integrity solutions.
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Live webinar: integrating pre and postpay programs for optimal FWA results
Register todayWhile 2021 has brought renewed optimism over the COVID-19 pandemic, it has also delivered numerous new fraud, waste, and abuse (FWA) cases in healthcare.
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To successfully transition from paying for volume to paying for value, Medicare Advantage plans must take a more innovative approach to provider engagement.
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Learn how Health Partners Plans of Pennsylvania successfully recovered more than $1 million in overpayments related to upcoding from a provider group in partnership with Cotiviti.
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Health plans complete in-home health assessments (often called health risk assessments) for their members for several reasons: accurately documenting members’ risk burden, supporting...
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Coordination of benefits (COB) requires health plans to navigate significant complexities. The order of benefit determination rules rely on an ever-changing member landscape that is as...
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Payers continue to invest in innovative techniques to prevent improper payments, rather than “pay and chase." Learn how health plans can successfully navigate the challenges of prospective validation.
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Avoid payment errors and increase prospective savings
Learn howAs many health plans know, achieving a higher Star Rating will soon be more challenging. The Centers for Medicare & Medicaid Services (CMS) is changing the makeup of the rating system,...
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While the COVID-19 pandemic has challenged providers in significant ways, it unfortunately has also created new opportunities for a small handful of bad actors to take advantage of the...
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While COVID-19 has shifted many healthcare payers' priorities in the past year, organizations are also looking at where they will make their long-term technology investments once the...
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Calculate your risk adjustment opportunity with Cotiviti
See the calculatorRisk adjustment—and the complex nature of the processes involved—is often misunderstood. Learn the fundamentals health plans must master to be successful.
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Cotiviti's Signature Series features interviews with senior health plan leaders on how to improve clinical and financial outcomes in healthcare.
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The COVID-19 pandemic has led to unprecedented challenges for Medicaid plans. Here are five areas that Medicaid plans should evaluate to protect their business in this environment.
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Cotiviti payment leaders explain how to optimize your coordination of benefits (COB) process to account for variable member life events to help ensure proper COB determinations.
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Learn how a major North Carolina health plan uses Cotiviti's Network Intelligence solution to support a provider specialty tiering program centered on value-based care.
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In the summer of 2020, Cotiviti released a new health risk map to help determine which states might see serious, medically attended novel coronavirus (COVID-19) cases. At the time, we...
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Cotiviti's senior leaders explain how to guard against healthcare fraud in 2021 amid recent CPT code updates coupled with permanent regulatory changes to telehealth.
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Choose Certainty with a proven leader in payment integrity, risk adjustment, quality, and analytics.
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As COVID-19 cases and deaths surge in several hot spots across the United States, many individuals and organizations continue to ask, “What else can we do to help protect ourselves, our...
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Learn how a major New York health plan worked with Cotiviti to realize more than $10.5 million in savings from one major investigation.
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