Busted: The top healthcare fraud schemes of Q4 2021
The top alleged healthcare fraud schemes in the fourth quarter of 2021 came in the form of kickbacks, falsified claims, overbilling, and more.
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Cotiviti Blog
Cotiviti is empowering a sustainable value-based healthcare delivery and payment system for health plans, employers, and providers.
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Analysis: Behavioral health conditions, risk, and cost during the COVID-19 pandemic
Learn how Cotiviti worked one client to evaluate the current state of behavioral health among its population and to identify specific areas of opportunity for monitoring and intervention.
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Webinar: Understand the 2022 CPT code changes
COVID-19 drastically impacted the healthcare system, from the supply chain down to medical billing codes. As variants and multiple vaccines developed, new codes were needed to...
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What’s old is new again: 3 healthcare fraud trends to watch for in 2022
Here are three common schemes special investigative units (SIUs) should expect to see persist in 2022 and how to combat them.
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CMS Innovation Center sharpens focus on health equity in new strategy refresh
CMS recently released its vision for the CMS Innovation Center in a white paper, Innovation Center Strategy Refresh, which will inform how value-based care payment models are designed and evaluated.
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Preparing for Medicaid renewals in 2022
With the COVID-19 public health emergency designation likely to expire in January 2022, learn how Medicaid plans can reduce churn.
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Preparing your payment integrity programs for 2022 and beyond
The COVID-19 pandemic continues to place great burdens on our healthcare system. As providers responded to the added challenges, a few bad actors predictably took advantage of the...
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3 reasons retrospective solutions are a vital part of claims payment integrity
Learn why the foundational value of retrospective solutions makes them a vital part of any successful enterprise payment integrity program.
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Podcast: Welcoming, onboarding, and retaining members in the new year
In this podcast, Cotiviti experts discuss member welcome, onboarding, and retention best practices for Medicare Advantage and Medicaid plans.
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RISE Webinar: Uniting risk adjustment, HEDIS, and Star Ratings initiatives
To eliminate silos in their organization and create a more holistic approach to accurate risk adjustment, HEDIS® scores, and Star Ratings, many health plans have embarked on significant...
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Busted: The top healthcare fraud schemes of Q3 2021
The most nefarious alleged healthcare fraud schemes of Q3 2021 included drug testing schemes, kickbacks, money laundering, and more.
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Could AI reduce healthcare waste?
Cotiviti EVP Nicole Neumarker explains how healthcare organizations can follow the example of online retailers in combatting waste.
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The Journey to 4-Star Performance: How Data Analytics Make the Difference
Cotiviti SVP Rachael Jones joins The Health Plan to discuss how to improve Star Ratings performance.
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Closing Gaps in Care for the Most Vulnerable
Writing for Journal of AHIMA, Cotiviti EVP RaeAnn Grossman explains how payers can improve care for vulnerable populations.
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Learning from 2022 Star Ratings and planning for 2023–2024
Learn how to interpret your 2022 Star Ratings and get a head start on changes for next year.
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Podcast: Embracing change in healthcare and beyond
Cotiviti SVP of Performance Analytics and Quality joins the HIT Like a Girl podcast to discuss her career, health equity, and healthcare sustainability.
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Staving off the “twindemic” by boosting flu immunization rates
As policymakers and other healthcare stakeholders focus on COVID-19 vaccinations, it can be easy to forget the importance of other life-saving immunizations.
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Execute healthcare claims editing more accurately—with less provider abrasion
Payers should consider several best practices when deploying a claim editing solution that pays claims with the highest accuracy and the lowest provider abrasion.
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4 best practices to prevent rapid disenrollment for Medicare Advantage plans
Here are four proven best practices to remember as you build or improve upon your disenrollment prevention strategy.
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Boosting childhood vaccination rates amid a resurging pandemic
Routine pediatric immunizations are down worldwide. The World Health Organization and UNICEF reported that about 23 million children missed out on basic childhood vaccines last year—one...
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