Busted: The top healthcare fraud schemes of Q4 2021
The top alleged healthcare fraud schemes in the fourth quarter of 2021 came in the form of kickbacks, falsified claims, overbilling, and more.
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Our latest healthcare payer resources
Improve your payment, risk, and quality outcomes with the latest healthcare insights from Cotiviti's leading experts including customer case studies, webinars, white papers, and articles.
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Understanding the 2022 CPT code changes %% Watch the on-demand webinar
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Analysis: Behavioral health conditions, risk, and cost during the COVID-19 pandemic
Learn how Cotiviti worked one client to evaluate the current state of behavioral health among its population and to identify specific areas of opportunity for monitoring and intervention.
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What’s old is new again: 3 healthcare fraud trends to watch for in 2022
Here are three common schemes special investigative units (SIUs) should expect to see persist in 2022 and how to combat them.
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Proven strategies to jumpstart HEDIS and Star Ratings success in 2022 %% Watch the on-demand webinar
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CMS Innovation Center sharpens focus on health equity in new strategy refresh
CMS recently released its vision for the CMS Innovation Center in a white paper, Innovation Center Strategy Refresh, which will inform how value-based care payment models are designed and evaluated.
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Preparing for Medicaid renewals in 2022
With the COVID-19 public health emergency designation likely to expire in January 2022, learn how Medicaid plans can reduce churn.
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RISE Webinar: Uniting risk adjustment, HEDIS, and Stars
Learn a "next best action" approach to analytics at the member level with the potential to deliver tangible impact for both risk adjustment and quality improvement programs.
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The right payment integrity intervention at the right time %% Watch the on-demand webinar featuring our payment integrity leaders
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3 reasons retrospective solutions are a vital part of claims payment integrity
Learn why the foundational value of retrospective solutions makes them a vital part of any successful enterprise payment integrity program.
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Avoid payment errors and increase prospective savings
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A proven approach to preventing E&M over-coding
Cotiviti Chief Medical Officer Richard Pozen, M.D., explains how payers can tackle challenging Level 4 and 5 E&M claims while still paying claims promptly and minimizing abrasion.
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Podcast: Welcoming, onboarding, and retaining members in the new year
In this podcast, Cotiviti experts discuss member welcome, onboarding, and retention best practices for Medicare Advantage and Medicaid plans.
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Learning from 2022 Star Ratings and planning for 2023–2024
Learn how to interpret your 2022 Star Ratings and get a head start on changes for next year.
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Calculate your risk adjustment opportunity with Cotiviti
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Busted: The top healthcare fraud schemes of Q3 2021
The most nefarious alleged healthcare fraud schemes of Q3 2021 included drug testing schemes, kickbacks, money laundering, and more.
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Closing Gaps in Care for the Most Vulnerable
Writing for Journal of AHIMA, Cotiviti EVP RaeAnn Grossman explains how payers can improve care for vulnerable populations.
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Staving off the “twindemic” by boosting flu immunization rates
As policymakers and other healthcare stakeholders focus on COVID-19 vaccinations, it can be easy to forget the importance of other life-saving immunizations.
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Podcast: Embracing change in healthcare and beyond
Cotiviti SVP of Performance Analytics and Quality joins the HIT Like a Girl podcast to discuss her career, health equity, and healthcare sustainability.
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Cotiviti GOV Services
Enabling government agencies to maintain payment integrity, optimize risk adjustment, and improve quality outcomes
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Execute healthcare claims editing more accurately—with less provider abrasion
Payers should consider several best practices when deploying a claim editing solution that pays claims with the highest accuracy and the lowest provider abrasion.
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4 best practices to prevent rapid disenrollment for Medicare Advantage plans
Here are four proven best practices to remember as you build or improve upon your disenrollment prevention strategy.
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Prioritizing prepayment integrity savings strengthens health plan's competitive position
Read our Savings Spotlight and learn how one health plan with just under 100,000 members achieved a 3.9% annual prepay savings rate with Cotiviti in 2020.
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Boosting childhood vaccination rates amid a resurging pandemic
Routine pediatric immunizations are down worldwide. The World Health Organization and UNICEF reported that about 23 million children missed out on basic childhood vaccines last year—one...
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Research: Optimizing payment integrity with enterprise pre and postpayment solutions
Cotiviti surveyed health plan leaders to investigate the challenges their organizations are facing with balancing prospective and retrospective payment integrity programs.
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