Prepay FWA review leads to >$100,000 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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Fraud, Waste, and Abuse
Fraud, waste, and abuse (FWA) remains one of healthcare's greatest challenges. These resources from Cotiviti offer best practices to prevent and catch FWA.
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Sequencing investigative activities for greater provider impact%%Attend the live webinar on Tuesday, March 28
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Podcast: How health plans investigate and prevent FWA
Cotiviti VP of Fraud, Waste, and Abuse Erin Rutzler joins the Healthcare de Jure podcast to discuss the ins and outs of healthcare fraud prevention and management.
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SIU panel discussion%% Watch the on-demand webinar and optimize your SIU
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Busted: The top fraud schemes of Q4 2022
Cotiviti rounds up some of the most prominent cases of alleged healthcare fraud from the fourth quarter of 2022.
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Catching potential drug testing fraud%%Watch the on-demand webinar
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FWA Insights: Navigating 2023 CPT code changes
Explore the latest CPT code updates and areas for payers to scrutinize in the new year.
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Detect and deter FWA while meeting compliance and financial goals
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The payment integrity playbook for success in 2023 and beyond
In our newly updated eBook, we offer insight into how you can develop a solid foundation for holistic payment success across your critical programs.
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Preparing for investigative FWA strategies in 2023%%Watch on demand
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FWA Insights: Catching improper billing within genetic testing and molecular pathology
Learn different FWA patterns specific to genetic testing services from Cotiviti’s SIU.
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Maintaining a strong and successful SIU in 2023
As the “Great Resignation” continues to impact health plan staffing, here are 5 tips to help your health plan retain SIU employees and foster team bonding.
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Busted: The top fraud schemes of Q3 2022
Read our summary of the most prominent cases of alleged healthcare fraud from July through September 2022.
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FWA Insights: Managing FWA for dental claims
Learn the latest in dental FWA and explore best practices for prevention.
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FWA Insights: Spotting overpayments in mental health services
Learn how Cotiviti’s SIU uncovered an overpayment of over $2 million related to mental health services.
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FWA Insights: Catching inappropriate billing within ASD services
Learn how Cotiviti's SIU caught a fraudulent pattern within applied behavior analysis.
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FWA Insights: Flagging for excessive modifiers
Learn how Cotiviti helped one plan identify inappropriate modifiers leading to the identification of a >$1 million overpayment.
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FWA Insights: Spotting red flags in adult day care claims
Learn how Cotiviti’s SIU identified an adult day care scheme that led to a $1 million overpayment.
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FWA Insights: Flagging potential physical therapy schemes
Learn how Cotiviti’s SIU flagged an excess of CPT 97799 codes through prepayment review and data analysis.
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FWA Insights: How to catch a DME scheme
Learn how Cotiviti’s eagle-eyed SIU caught a chiropractor billing multiple times for durable medical equipment (DME).
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Busted: The top fraud schemes of Q1 2022
Learn about the latest indictments related to healthcare fraud, waste, and abuse (FWA) targeting both public and private payers.
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Rising telehealth: Catching FWA in behavioral health claims
Discover how the pandemic affected behavioral health claims and learn different tactics for avoiding fraud, waste, and abuse.
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Specialty Drugs: Ensuring payment accuracy beyond prior authorizations
While many plans lean on prior authorizations to ease the processing of specialty drug claims, our experts explore more comprehensive options for getting claims paid more accurately—and more quickly.
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Busted: The top healthcare fraud schemes of Q4 2021
The top alleged healthcare fraud schemes in the fourth quarter of 2021 came in the form of kickbacks, falsified claims, overbilling, and more.
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What’s old is new again: 3 healthcare fraud trends to watch for in 2022
Here are three common schemes special investigative units (SIUs) should expect to see persist in 2022 and how to combat them.
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