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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Case Studies
Learn how Cotiviti's customers solved their healthcare challenges in partnership with our organization.
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Prepay FWA review leads to >$100,000 in projected annual savings
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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 coordination of benefits (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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New York health plan cracks massive diagnostic testing scheme for prepay FWA savings
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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Accelerating value-driven care: A comprehensive approach to provider specialty tiering
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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Advanced analysis and collaboration drives $1M+ overpayment recovery success for Health Partners Plans
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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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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