Star Ratings reset: How MA plans can prepare
Learn the most impactful changes proposed in November 2025 to the CMS Star Ratings program and how to pivot for success in 2026.
Read Blog
Cotiviti Blog
Cotiviti is empowering a sustainable value-based healthcare delivery and payment system for health plans, employers, and providers.
-
-
FWA Insights: Billing for services not rendered
Learn key red flags to look for in healthcare fraud schemes involving services not rendered and how Cotiviti helped identify a multimillion-dollar scheme.
Read Blog
-
Navigating the 2026 ICD-10-CM coding updates
Review key ICD-10-CM updates and adopt best practices to prepare, adjust, and thrive in the new year.
Read Blog
-
Podcast: An innovation roadmap for risk adjustment strategies
Senior leaders from Cotiviti and Edifecs offer strategies for building scalable risk adjustment technology initiatives while navigating rising business and regulatory pressures.
Read Blog
-
Achieving Star Ratings success in the ECDS era
Learn how to maintain or even boost your Star Ratings as hybrid measures are retired and digital quality becomes the norm.
Read eBook
-
A proven approach to preventing E/M over-coding without increasing provider abrasion
Learn the latest insights and approaches to preventing E/M over-coding.
Read Blog
-
eBook: Setting up for coordination of benefits (COB) success
A robust coordination of benefits (COB) program can be one of the most difficult elements for health plans to achieve in creating a stronger payment integrity strategy. As rising...
Read Blog
-
The practical landscape of AI in payment integrity and VBP
Learn how artificial intelligence can be deployed practically to improve payment integrity and value-based payment operations.
Read Blog
-
FWA Insights: Stopping “phantom providers” with prepay intervention
Learn how phantom provider schemes work and how to stop them with prepay fraud, waste, and abuse interventions.
Read Blog
-
How to create a comprehensive risk adjustment program
Combine prospective, concurrent, and retrospective approaches for a comprehensive risk adjustment program.
Read Blog
-
2026 Star Ratings: What they mean and what comes next
Review the 2026 Star Ratings results, examine key measures and cut point impacts, and learn practical recommendations for boosting Star Ratings performance.
Read Blog
-
Protecting employees' healthcare dollars
Learn how self-insured employers can safeguard their employees' healthcare premiums with robust payment integrity programs.
Read White Paper
-
Webinar: Navigating 2026 coding updates for risk adjustment success
2026 is coming up fast and health plans should be preparing risk adjustment programs accordingly, with coding accuracy as critical as ever for securing appropriate reimbursement and...
Read Blog
-
FWA Insights: Appropriate billing of intensive outpatient programs
Learn how to spot red flags in billing for intensive outpatient programs (IOPs) with these insights from Cotiviti's FWA team.
Read Blog
-
Preparing for 2026: Adapting to new risk adjustment regulations
Learn the impact of the latest changes in risk adjustment for 2026 and beyond.
Read Blog
-
MY 2026: Breaking down the latest HEDIS Technical Specifications
Read a structured breakdown of confirmed changes to the MY 2026 HEDIS Technical Specifications and strategies to enable health plans to prepare.
Read Blog
-
Case study: Regional plan exceeds expectations with second-pass COB
Coordination of benefits (COB) is an intricate, time-consuming process for all health plans—sifting through data assets, checking validity, establishing primacy, and more. But having a...
Read Blog
-
Star Ratings Plan Preview: 4 key recommendations
As we await publication of the final 2026 Star Ratings, learn why scores are dropping and strategies for MA plans to close out the calendar year with stronger performance.
Read Blog
-
Busted: The top fraud schemes of Q2 2025
Read our breakdown of 10 major healthcare FWA schemes from April through June 2025—and what they reveal about the evolving tactics of bad actors.
Read Blog
-
Payment Policy Insights: The evolution of physical therapy
Learn three key trends across physical therapy in outpatient and professional settings—and the implications for health plans.
Read Blog
-
Loading More...
