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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