Claim Pattern Review solution
Prevent FWA before claims are paid and flag providers that warrant immediate investigation
Cotiviti’s prospective Claim Pattern review solution analyzes prepay claims and other data points to identify potential patterns of FWA and prevent those claims from being paid while still meeting prompt-pay requirements. Our solution also flags suspicious providers that warrant immediate investigation, helping special investigative units (SIUs) build ironclad cases to stop bad actors sooner.
- Rapid ROI through automated detection while meeting prompt-pay laws
- Projected savings of 0.30% of annual professional claim spend
- Potential fraud cases identified earlier to improve payment integrity
- Increased SIU staff productivity without displacing current resources or systems