While the COVID-19 pandemic has challenged providers in significant ways, it unfortunately has also created new opportunities for a small handful of bad actors to take advantage of the...
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Healthcare fraud, waste, and abuse (FWA) accounts for up to 10 percent of total healthcare spend—and the vast majority of those dollars are never recovered. While health plans try to...
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Detect and deter fraud, waste, and abuse while meeting compliance and financial goals
Learn howCotiviti's senior leaders explain how to guard against healthcare fraud in 2021 amid recent CPT code updates coupled with permanent regulatory changes to telehealth.
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Learn how Health Partners Plans of Pennsylvania successfully recovered more than $1 million in overpayments related to upcoding from a provider group in partnership with Cotiviti.
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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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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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Learn how a major New York health plan worked with Cotiviti to realize more than $10.5 million in savings from one major investigation.
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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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Learn best practices for preventing healthcare fraud, waste, and abuse, avoiding the need to "pay and chase" when fraudulent payments occur.
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We’ve created a checklist with eight practical tips that will help you navigate Excel efficiently and spot potential trends during your FWA investigations.
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Learn how a Minnesota payer serving more than 2.5 million members caught a chiropractor's fraudulent scheme and reported it to law enforcement.
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Numerous bad actors in healthcare continued to be at large in 2020, exploiting the COVID-19 health crisis and taking advantage of health plans and their members. In Q4, healthcare fraud...
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Prevent FWA before claims are paid and flag providers that warrant immediate investigation
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Detect and deter fraud, waste, and abuse (FWA) while meeting compliance and financial goals
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Investigative and clinical support for health payers
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