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
Cotiviti Blog
Cotiviti is empowering a sustainable value-based healthcare delivery and payment system for health plans, employers, and providers.
-
-
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
-
Webinar: Deploying AI effectively and responsibly in payment integrity
Artificial intelligence (AI) is unlocking numerous possibilities for payers to make costs more sustainable without a negative impact on care quality. According to McKinsey estimates,...
Read Blog
-
FWA Insights: Q&A with the SIU
Cotiviti's FWA investigators break down complex questions related to skin grafts and substitutes, a growing area of concern in healthcare.
Read Blog
-
The journey to four stars: How one plan transformed its Star Ratings strategy
Learn how Star Intelligence powers data-driven decision-making for one regional health plan as it seeks to improve Star Ratings outcomes.
Read Case Study
-
Blue Plan expands Cotiviti DRG review program amid early success
Learn how one Blue Plan adopted Cotiviti's DRG review solution and achieved triple its original projected findings with Clinical Chart Validation.
Read Case Study
-
FWA Insights: Identifying a DME dropshipping scheme
Learn how Cotiviti identified a DME provider that ordered items from a large online retailer, then billed the health plan at heavily marked up rates.
Read Blog
-
Regional plan exceeds expectations with second-pass COB
Learn how a regional health plan enlisted the help of Cotiviti’s retrospective COB Validation solution and started seeing results fast.
Read Case Study
-
Decoding HEDIS® MY 2024 for success in MY 2025
Learn key takeaways from the HEDIS MY 2024 season along with measure and timeline changes that will impact health plans for MY 2025.
Read Blog
-
Loading More...
