FWA Insights: Solving durable medical equipment (DME) challenges
Learn how Cotiviti's investigators took action when one provider stood out for excessive durable medical equipment (DME) billing of Medicare.
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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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Everest Group names Cotiviti the highest-designated Leader in Payment Integrity%%Read the Payment Integrity Solutions PEAK Matrix® Assessment 2025
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Payment integrity: Unlocking the value of complex outpatient reviews
Learn about one of the most impactful and often underutilized tools in a high-performing payment integrity program: the complex outpatient review.
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Quality Decoded webinar series%%Register for critical HEDIS and Star Ratings updates
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Key commercial risk adjustment updates as 2026 approaches
Learn about key changes to the commercial risk adjustment program from the 2026 Payment Notice as we offer key strategies for health plans to prepare and strengthen their efforts.
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Busted: The top fraud schemes of Q1 2025
Read our summary of how bad actors allegedly deployed kickbacks, false claims, and exploitation of vulnerable patients to defraud health plans in Q1 of 2025.
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Prepay coordination of benefits (COB) boosts payment integrity results for large national payer
Learn how health plans can prevent overpayments, reduce future erroneous payments, and confirm that primary payment responsibility is correctly assigned—all while lowering provider abrasion.
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Decoding the 2026 CMS Final Rule
Watch as we summarize the 2026 Medicare Advantage and Part D Final Rule and its implications for the Star Ratings program.
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Visit our YouTube channel%%Subscribe for our latest webinars and more
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3 updates from the 2026 CMS Final Rate Announcement
CMS has finalized a >5% payment increase in the Medicare Advantage and Part D Rate Announcement for calendar year 2026.
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FWA Insights: Skin grafts and substitutes
Learn how prepay FWA review identified over half a million dollars in skin substitute overpayments for one client.
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Unparalleled analytics inform key payment integrity decisions for large payer
Discover how cross-payer analytics drove payment integrity success for one of Cotiviti's health plan clients.
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Payment Integrity Pulse: 2025 regulatory and market changes
Learn more about the impact of CPT code changes in E/M, the shift from inpatient to outpatient utilization, and more.
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Talk with an expert %% Learn more about how our solutions can help you meet your goals
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Busted: The top healthcare fraud schemes of Q4 2024
Some of the most prominent FWA cases of Q4 2024 included fraudulent billing, illegal kickbacks, and other misconduct that frequently jeopardized patient safety.
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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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FWA Insights: Reducing audit abrasion
Learn how a more collaborative, transparent approach to provider audits can help health plans maintain compliance while fostering productive provider relationships.
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Closing the Gap%%Improve care gap closure through targeted quality improvement and member engagement
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Decoding the HEDIS MY 2026 public comment period
Watch our brief webinar to learn what you need to know about NCQA's proposed updates for HEDIS Measurement Year (MY) 2026.
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Regional Blue Plan performs beyond expectations with Data Mining
Learn how Cotiviti helped deliver a significant increase in overpayment recoveries through data mining expertise.
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NCQA releases proposed HEDIS MY 2026 updates
Learn NCQA's proposed new measures, measure retirements, and other changes for HEDIS Measurement Year (MY) 2026.
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Prioritizing prepay integrity strengthens mid-sized health plan's competitive position
Learn how one mid-sized health plan uses prepay claim editing to improve its competitive position.
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Decoding the 2026 CMS Advance Notice
Review the 2026 CMS Medicare Advantage and Part D Advance Notice as we break down proposed measure and policy changes from a quality perspective.
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FWA Insights: Changes to audio-only telehealth codes sheds light on FWA
Learn how health plans can stay vigilant for FWA amid CMS’s changing telehealth guidelines.
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Prepare for success in Medicare Advantage risk adjustment
Learn how to bolster risk adjustment efforts with our best practices.
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