7 key steps to build a valuable COB program
Explore the 7 steps to build a successful COB program.
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Explore the 7 steps to build a successful COB program.
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Learn how Cotiviti's SIU identified a recent scheme in this common area of healthcare fraud, waste, and abuse (FWA).
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Learn three essential strategies to help payers maximize the value of their interoperability investments as key industry deadlines draw closer.
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Learn why one large Medicaid plan realizes value from Cotiviti's prepay solutions and differentiated service model.
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As procedures that were once strictly performed in hospitals move to outpatient facilities, patients and providers alike are witnessing a shift that promises both opportunity and challenges.
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Learn about the three key values that guide Cotiviti's relationship with our clients: transparency, authenticity, and accountability.
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Learn the top dental procedures that are frequently misused as we examine their causes, consequences, and the steps necessary to mitigate the effects of fraudulent and abusive billing.
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The conclusion of another HEDIS® season offers health plans an important opportunity to evaluate their performance, uncover key takeaways from the past year, and realign priorities for...
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Learn how Cotiviti's SIU identified excessive billing for dental restorations to safeguard payment integrity and appropriate member care.
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Learn three key trends shaping emergency department (ED) E/M claims as we examine their impact on payers and payment integrity programs.
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Learn how to prepare for CMS's new risk adjustment audit methodology for Medicare Advantage plans in 2025 and beyond.
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Learn how a multi-state managed care organization identifies complex pharmacy errors and more with Cotiviti’s solutions.
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Learn about key updates from the CMS Final Rule and how to prepare for Star Ratings success in 2026 and beyond.
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Learn how Cotiviti's investigators took action when one provider stood out for excessive durable medical equipment (DME) billing of Medicare.
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Learn about one of the most impactful and often underutilized tools in a high-performing payment integrity program: the complex outpatient review.
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Learn about key changes to the commercial risk adjustment program from the 2026 Payment Notice as we offer key strategies for health plans to prepare and strengthen their efforts.
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Read our summary of how bad actors allegedly deployed kickbacks, false claims, and exploitation of vulnerable patients to defraud health plans in Q1 of 2025.
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Learn how health plans can prevent overpayments, reduce future erroneous payments, and confirm that primary payment responsibility is correctly assigned—all while lowering provider abrasion.
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CMS has finalized a >5% payment increase in the Medicare Advantage and Part D Rate Announcement for calendar year 2026.
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Learn how prepay FWA review identified over half a million dollars in skin substitute overpayments for one client.
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