Prepay claims editing improves payment accuracy for self-funded employers
Learn how Cotiviti helped one benefit administrator prevent $28M in inappropriate payments for clients.
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Cotiviti Case Studies
Learn how Cotiviti's health plan customers solved their challenges in payment integrity, risk adjustment, quality improvement, and member engagement.
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Highmark Wholecare prevents FWA with Claim Pattern Review
Learn how Highmark Wholecare prevented improper payments and FWA with Cotiviti's prepayment integrity solution.
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Health plan finds new value with AI-enabled clinical reviews
See how the safe application of AI can drive additional value and improve health plan results—without replacing human expertise.
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National health plan deploys Eliza for secure digital engagement with members
Learn how one national health plan deployed Eliza to launch an innovative campaign with secure digital-linked text messages, IVR outreach, and email to reach members with diverse care needs.
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Health plan protects financial integrity with prepay review solutions
Learn how the largest Medicaid payer in one state protects its financial integrity with Payment Policy Management and Coding Validation.
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FWA Insights: Prepay review leads to >$100K in projected annual savings
Learn how Cotiviti's SIU identified a suspicious pattern of psychotherapy claims from one provider, preventing inappropriate claims from being paid.
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Unlocking valuable SDoH data and connecting members to care with Eliza secure digital outreach
Learn how one large regional health plan reached >90% of its targeted members with multi-channel outreach.
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Medicare Advantage plan reduces inappropriate payments by millions with Claim Pattern Review
Learn how one Medicare Advantage plan prevented more than $1 million inappropriate payments in less than a year with Claim Pattern Review.
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Discover the impact of prospective DRG validation
Learn how Clinical Chart Validation enabled one plan to streamline and optimize DRG review while improving quality and the provider experience.
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Medicaid plans leverage Eliza to reach members during redetermination
Learn how three health plans of all sizes worked with Cotiviti to conduct redetermination campaigns with Eliza, Cotiviti's multi-channel consumer engagement platform.
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Data Mining for pharmacy payment errors yields high savings
See how Cotiviti’s Data Mining pharmacy solution uncovered millions in inaccurate payments for two health plans using predictive analytics and specialist validation.
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Large, multi-state plan realizes significant savings in a complex environment
Read our Savings Spotlight and learn how a multi-state plan increased its prepay savings with Payment Policy Management.
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Large regional plan integrates Coding Validation into existing prepay solution to drive incremental savings
Read our Savings Spotlight and learn how a large plan deployed Payment Policy Management and Coding Validation for significant incremental savings and reduced abrasion.
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Leading New York plan’s operational improvements, mature policy library refinement contributes to substantial savings
Read our Savings Spotlight and learn how a large New York plan achieved better operational efficiency and savings with Payment Accuracy solutions.
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National health plan grows cost containment value with end-to-end Payment Accuracy solutions
Read our Savings Spotlight and learn how a large national health plan deployed end-to-end Payment Accuracy solutions for better prevention of inappropriate claims and savings.
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Prepay COB boosts payment integrity results for large national plan
Learn how a Cotiviti client achieved a >99% conversion rate with prospective and retrospective COB Validation.
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How quality insights and collaboration improve quality and performance for a large nonprofit health plan
Learn how one large nonprofit health plan uses Cotiviti’s Quality Intelligence to support year-round initiatives across HEDIS, Star Ratings, and more.
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Optimize and expedite DRG review with Clinical Chart Validation
Learn how Cotiviti's new cross-claim clinical review feature adds incremental value and can speed the DRG review process without sacrificing accuracy.
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Dental claim review expertise nets significant savings with minimal abrasion for large dental payer
Learn how one payer partners with Cotiviti to augment the capabilities of its own dental reviewers and internal claim editing system with prepay, post-adjudication dental claims review.
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Prioritizing prepayment integrity savings strengthens health plan's competitive position
Read our Savings Spotlight and learn how one health plan improved its prepay savings with Payment Policy Management.
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