While COVID-19 has shifted many healthcare payers' priorities in the past year, organizations are also looking at where they will make their long-term technology investments once the...
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Cotiviti's Signature Series features interviews with senior health plan leaders on how to improve clinical and financial outcomes in healthcare.
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The COVID-19 pandemic has led to unprecedented challenges for Medicaid plans. Here are five areas that Medicaid plans should evaluate to protect their business in this environment.
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As the COVID-19 pandemic continues, fraudsters have adapted their behavior to circumvent ongoing investigations and fraud detection. As a result, health plans may be vulnerable to new schemes.
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As the novel coronavirus (COVID-19) pandemic continues to heavily impact our healthcare system, guidance on coding and processing claims related to COVID-19 continues to evolve. Payment...
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Payment leaders from Highmark BlueCross BlueShield and Cotiviti discuss the impact of COVID-19 on payment integrity.
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As payers ramp up their efforts to manage the coronavirus (COVID-19) outbreak, it’s important they stay alert of possible fraud, waste, and abuse (FWA) schemes.
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In the summer of 2020, Cotiviti released a new health risk map to help determine which states might see serious, medically attended novel coronavirus (COVID-19) cases. At the time, we...
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As routine medical services are cancelled or postponed due to COVID-19, prospective risk scores used to pay Medicare Advantage (MA) health plans in 2021 are trending lower than...
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As COVID-19 cases and deaths surge in several hot spots across the United States, many individuals and organizations continue to ask, “What else can we do to help protect ourselves, our...
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The COVID-19 pandemic has created opportunity for bad actors to exploit vulnerabilities in the healthcare system—as well as capitalize on fear. From offering phony testing to peddling...
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Understanding how individuals vary on disease susceptibility is becoming increasingly important for clinicians to deliver effective treatment to their patients. For example, some...
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What if the healthcare industry could predict the future … the outcome of interventions, the onset of preventable and chronic conditions, or the spread of pandemic? How valuable would...
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As numerous regions around the country see surges of COVID-19 outbreak, Cotiviti's Outbreak Tracker continues to accurately predict which counties are at risk within the next seven to...
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The extraordinary increase in telehealth usage during the COVID-19 pandemic has opened the door for potential healthcare fraud, waste, and abuse (FWA), particularly around upcoding....
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