FWA Insights: Identifying a DME dropshipping scheme
Learn how Cotiviti identified a DME provider that ordered items from a large online retailer, then billed the health plan at heavily marked up rates.
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Our latest healthcare payer resources
These resources from Cotiviti help power better payment integrity, risk adjustment, quality reporting, and consumer engagement programs for healthcare payers.
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Decoding the HEDIS Tech Specs for MY 2026%%Register for our next Quality Decoded webinar on 9/4
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Perform Beyond Hype: Going beyond buzzwords in healthcare
Learn how Cotiviti performs beyond hype with deep clinical expertise, responsible innovation, and lasting partnerships.
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Deploying AI effectively and responsibly in payment integrity%%Register for our 9/25 webinar
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Decoding HEDIS® MY 2024 for success in MY 2025
Learn key takeaways from the HEDIS MY 2024 season along with measure and timeline changes that will impact health plans for MY 2025.
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Payment policy trends and insights%%Watch our Payment Integrity Pulse webinar on demand
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7 key steps to build a valuable COB program
Learn how to build a comprehensive, member-centric COB program with prompt monitoring, accurate data, and auditing expertise.
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Perform Beyond Silos: Uniting people, programs, and partners across healthcare
Learn how Cotiviti’s solutions and delivery model perform beyond silos by bridging program gaps and aligning efforts across departments.
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Everest Group names Cotiviti the highest-designated Leader in Payment Integrity%%Read the Payment Integrity Solutions PEAK Matrix® Assessment 2025
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FWA Insights: Uncovering improper billing in urine drug screens
Learn how Cotiviti's SIU identified a recent scheme in this common area of healthcare fraud, waste, and abuse (FWA).
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Decoding the HEDIS MY 2024 season
Join Cotiviti's Quality and Stars experts as they celebrate MY 2024 successes and review strategies to improve in MY 2025.
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Unlocking business value through interoperability: 3 key strategies
Learn three essential strategies to help payers maximize the value of their interoperability investments as key industry deadlines draw closer.
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Visit our YouTube channel%%Subscribe for our latest webinars and more
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Large Medicaid payer protects taxpayer dollars, financial integrity with prepay review
Learn why one large Medicaid plan realizes value from Cotiviti's prepay solutions and differentiated service model.
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CCC25: 3 key pillars required to perform beyond healthcare challenges
Learn about the three key values that guide Cotiviti's relationship with our clients: transparency, authenticity, and accountability.
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Talk with an expert %% Learn more about how our solutions can help you meet your goals
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Navigating dental claim FWA: The impact of abused codes and claim splitting
Learn the top dental procedures that are frequently misused as we examine their causes, consequences, and the steps necessary to mitigate the effects of fraudulent and abusive billing.
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Prepay coordination of benefits (COB) boosts payment integrity results for large national payer
Learn how health plans can prevent overpayments, reduce future erroneous payments, and confirm that primary payment responsibility is correctly assigned—all while lowering provider abrasion.
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Unlocking value from interoperability investments
Watch our on-demand RISE webinar to gain expert insights on how to navigate interoperability challenges, enhance data connectivity, and drive measurable value for your organization.
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Closing the Gap%%Improve care gap closure through targeted quality improvement and member engagement
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Optimizing payment integrity for emergency department E/M claims
Learn three key trends shaping emergency department (ED) E/M claims as we examine their impact on payers and payment integrity programs.
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FWA Insights: Excessive dental restorations
Learn how Cotiviti's SIU identified excessive billing for dental restorations to safeguard payment integrity and appropriate member care.
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Risk adjustment: 4 strategies as CMS increases RADV audits
Learn how to prepare for CMS's new risk adjustment audit methodology for Medicare Advantage plans in 2025 and beyond.
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Medical pharmacy data mining innovation uncovers significant findings for large national plan
Learn how a multi-state managed care organization identifies complex pharmacy errors and more with Cotiviti’s solutions.
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Avoid payment errors and increase savings with these resources
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Star Ratings: 4 recommendations for the 2026 CMS Final Rule
Learn about key updates from the CMS Final Rule and how to prepare for Star Ratings success in 2026 and beyond.
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FWA Insights: Solving durable medical equipment (DME) challenges
Learn how Cotiviti's investigators took action when one provider stood out for excessive durable medical equipment (DME) billing of Medicare.
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Payment integrity: Unlocking the value of complex outpatient reviews
Learn about one of the most impactful and often underutilized tools in a high-performing payment integrity program: the complex outpatient review.
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