Keeping pace with the constant updates to HCPCS codes, CPT codes, and both local and national coverage determinations is no small feat for any payment integrity team. Adding to this complexity are evolving mandates, significant shifts in utilization trends, and the rapid introduction of new specialty drugs. These factors collectively challenge the payment integrity process, requiring health plans to be extra diligent in preventing or recovering inappropriate payments so they can optimize member care.

New in 2025, Cotiviti’s Payment Integrity Pulse webinar series is tailored for payment integrity leaders and experts, delivering up-to-date insights on payment integrity regulations, trends, and innovations. This quarterly webinar series offers expert advice on navigating the complexities of payment integrity throughout the year.

During this 45-minute webinar, the first of our series, we’ll break down:

• The impacts of CPT code changes in E/M: From new telemedicine codes to shifting time requirements, we’ll break down what these changes mean to your payment integrity efforts.
• The shift from inpatient to outpatient utilization: As healthcare utilization continues to migrate to urgent care settings, ambulatory surgical centers, and other options, we’ll examine how this impacts your claim review processes.
• Medical drug policy challenges: With specialty drug spending showing no signs of abating, we’ll discuss how payers can avoid high-dollar overpayments by helping to ensure these claims are examined and paid appropriately.