Health plan finds new value with AI-enabled clinical reviews
See how the safe application of AI can drive additional value and improve health plan results—without replacing human expertise.
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Case Studies
Learn how Cotiviti's customers solved their healthcare challenges in partnership with our organization.
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National health plan deploys Eliza for secure digital engagement with members
Learn how one national health plan deployed Eliza to launch an innovative campaign with secure digital-linked text messages, IVR outreach, and email to reach members with diverse care needs.
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Health plan protects financial integrity with prepay review solutions
Learn how the largest Medicaid payer in one state protects its financial integrity with Payment Policy Management and Coding Validation.
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Unlocking valuable SDoH data and connecting members to care with Eliza secure digital outreach
Learn how one large regional health plan reached >90% of its targeted members with multi-channel outreach.
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Prepay FWA review leads to >$100,000 in projected annual savings
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Medicare Advantage plan reduces inappropriate payments by millions with Claim Pattern Review
Learn how one Medicare Advantage plan prevented more than $1 million inappropriate payments in less than a year with Claim Pattern Review.
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Discover the impact of prospective DRG validation
Learn how Clinical Chart Validation enabled one plan to streamline and optimize DRG review while improving quality and the provider experience.
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Medicaid plans leverage Eliza to reach members during redetermination
Learn how three health plans of all sizes worked with Cotiviti to conduct redetermination campaigns with Eliza, Cotiviti's multi-channel consumer engagement platform.
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Data Mining for pharmacy payment errors yields high savings
See how Cotiviti’s Data Mining pharmacy solution uncovered millions in inaccurate payments for two health plans using predictive analytics and specialist validation.
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Large, multi-state plan realizes significant savings in a complex environment
Read our Savings Spotlight and learn how a multi-state plan increased its prepay savings with Payment Policy Management.
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Large regional plan integrates Coding Validation into existing prepay solution to drive incremental savings
Read our Savings Spotlight and learn how a large plan deployed Payment Policy Management and Coding Validation for significant incremental savings and reduced abrasion.
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Leading New York plan’s operational improvements, mature policy library refinement contributes to substantial savings
Read our Savings Spotlight and learn how a large New York plan achieved better operational efficiency and savings with Payment Accuracy solutions.
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National health plan grows cost containment value with end-to-end Payment Accuracy solutions
Read our Savings Spotlight and learn how a large national health plan deployed end-to-end Payment Accuracy solutions for better prevention of inappropriate claims and savings.
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Prepay COB boosts payment integrity results for large national plan
Learn how a Cotiviti client achieved a >99% conversion rate with prospective and retrospective COB Validation.
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How quality insights and collaboration improve quality and performance for a large nonprofit health plan
Learn how one large nonprofit health plan uses Cotiviti’s Quality Intelligence to support year-round initiatives across HEDIS, Star Ratings, and more.
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Optimize and expedite DRG review with Clinical Chart Validation
Learn how Cotiviti's new cross-claim clinical review feature adds incremental value and can speed the DRG review process without sacrificing accuracy.
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Dental claim review expertise nets significant savings with minimal abrasion for large dental payer
Learn how one payer partners with Cotiviti to augment the capabilities of its own dental reviewers and internal claim editing system with prepay, post-adjudication dental claims review.
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Prioritizing prepayment integrity savings strengthens health plan's competitive position
Read our Savings Spotlight and learn how one health plan improved its prepay savings with Payment Policy Management.
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Layered approach delivers pre and postpay savings for mid-sized health plan
Read our Savings Spotlight and learn how one mid-sized health plan increased pre and postpay savings with Payment Policy Management and Coding Validation.
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Strategic focus on prepayment claim accuracy leads to >$100M in savings for one Blue Plan
Read our Savings Spotlight and learn how one regional Blue Plan serving more than 4 million members increased prepay savings with Cotiviti's Payment Policy Management and Coding Validation.
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How a major Minnesota health plan built a strong case leading to a chiropractor's fraud conviction
Learn how a Minnesota payer serving more than 2.5 million members caught a chiropractor's fraudulent scheme and reported it to law enforcement.
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