Unlocking the value of employment verification in coordination of benefits
A one-size-fits-all approach rarely succeeds in employment verification. Here's a better strategy.
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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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Unlocking the value of employment verification in coordination of benefits
A one-size-fits-all approach rarely succeeds in employment verification. Here's a better strategy.
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Improving medical record retrieval: 5 best practices
Learn how to enhance retrieval success, improve outcomes, and foster collaboration—without increasing provider burden or placing strain on internal teams.
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Improving medical record retrieval: 5 best practices
As the healthcare industry adapts to rapid regulatory shifts, financial pressures, and evolving provider networks, health plans must optimize their approach to clinical data retrieval for...
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FWA Insights: The top fraud schemes of 2025
Mitigate FWA risks in 2026 with these lessons learned from 2025 in lab testing, home health and hospice, and telehealth.
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2027 CMS Advance Notice: 4 key updates
Understanding the 2027 CMS Advance Notice is crucial for optimizing plan performance, ensuring compliance, and maintaining a competitive edge.
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FWA Insights: Preventing overbilling in therapeutic home services
Learn how prospective analytics and expert review uncovered home health billing errors.
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3 key payment integrity trends to watch in 2026
As 2026 gets underway, here are three key shifts for payment integrity and compliance teams to monitor.
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E/M utilization and medical drug spend
Learn key trends in E/M utilization and medical drug spend as we address how payment integrity policies can play a proactive role in identifying billing errors.
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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.
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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.
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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.
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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.
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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.
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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.
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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...
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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.
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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.
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How to create a comprehensive risk adjustment program
Combine prospective, concurrent, and retrospective approaches for a comprehensive risk adjustment program.
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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.
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