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Dental Claim Accuracy

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Be certain about your payment integrity partner

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Accelerating value-driven care: A comprehensive approach to provider specialty tiering

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Turning the page on an unprecedented 2020 HEDIS season

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Finding payment integrity success in an evolving COVID-19 environment

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Under pressure: How Medicaid plans can overcome the inevitable strain of COVID-19

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Advancing value-based payment: One plan’s journey

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New York health plan cracks massive diagnostic testing scheme for pre-pay FWA savings

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Balancing prospective and retrospective claim payment accuracy

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FWA Validation

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Coding Validation

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Payment Policy Management

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Payment Data Validation

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Transitioning from post-payment recovery to prospective validation

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The HEDIS® 2020 path to success

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How HEDIS® recertification impacts health plans

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Performing more prospective validation of clinical claims

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Maximize the retrospective value chain

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Maximize the retrospective value chain

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The HEDIS 2020 path to success

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Busted: How a major Minnesota health plan built a strong case leading to a chiropractor’s fraud conviction

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Decoding the 2020 CPT® code changes

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The three fundamentals of risk adjustment success

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8 tips to help you find the FWA needle in the haystack with Excel

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Advanced analysis and collaboration drives >$1 million overpayment recovery success for Health Partners Plans

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The insider's guide to clinical appropriateness

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SIU Services

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Analysis: the financial impact of the 2019–2020 CMS-HCC risk adjustment model changes

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The continuous quest for quality

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Get more bang for your buck: adjusting pre-pay approaches in a changing landscape

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Get the facts: the clinical and financial impact of the CMS PY 2020 risk adjustment model

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How to step up claim overpayment recovery results

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Data integration and the emergence of answers to unsolvable problems

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The keys to successful claim overpayment recovery

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How to sharpen your inpatient auditing program with better chart selection

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Don’t lose your edge: commercial risk adjustment best practices

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Key takeaways from the 2020 Medicare Advantage and Part D Rate Announcement and Final Call Letter

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Excellus BlueCross BlueShield's data lake journey

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Powerful, nimble healthcare data analytics provide market differentiation for The Partners Group

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A path to success in the changing data management landscape

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10 tips for a seamless commercial risk adjustment program

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Cotiviti Solutions Flipbook

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Do this one thing right: make data a part of your business value

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Medical Intelligence for Employers and Brokers

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Contract Compliance

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Medical Record Coding

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Medical Record Retrieval

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Submissions

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Suspect Analytics

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In-Home Assessments

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FWA Management

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COB Validation

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Clinical Chart Validation

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Medical Record Abstraction

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Network Intelligence

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DxCG Intelligence

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Medical Intelligence

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Star Navigator

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Quality Intelligence

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Decoding the 2019 CPT® changes

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Quality and Performance solutions

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Payment Accuracy solutions

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Risk Adjustment solutions

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Survey: the changing quality improvement landscape

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The evolution of DxCG, the gold standard in risk adjustment and predictive modeling

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A new ecosystem for payer intelligence: How data lakes could feed insights for improved health

Podcast

Validating clinical claims without medical record review

Podcast

Fighting healthcare fraud and abuse with NHCAA

Podcast

HEDIS measure changes on the horizon