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