The payment integrity playbook for success in 2023 and beyond
In our newly updated eBook, we offer insight into how you can develop a solid foundation for holistic payment success across your critical programs.
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Payment Integrity
Optimize your prospective and retrospective payment integrity results with these resources from Cotiviti, including our latest white papers, on-demand webinars featuring senior payment experts, and case studies featuring Cotiviti clients.
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Managing a connected claim continuum%%Watch the on-demand webinar
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Rising telehealth: Catching FWA in behavioral health claims
Discover how the pandemic affected behavioral health claims and learn different tactics for avoiding fraud, waste, and abuse.
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The portfolio approach to managing complex payment integrity programs%%Watch the on-demand webinar
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How Data Mining helps clean up your claim payment stream
Learn how to leverage our analytics and data mining tools to recover high-value overpayments.
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Ensuring accuracy of specialty drug claims %% Watch our on-demand webinar
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3 key tips for managing your payment integrity portfolio
Payment integrity is a complex and layered process that requires health plans to look across the silos of their own organization and often use multiple vendors to create an integrated...
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Video: How to shorten time to payment integrity results
Learn how Cotiviti delivers as much as 80% of payment integrity savings before payment occurs—with robust auditing of complex claims that must be processed postpayment.
Watch Video
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Optimize and expedite DRG review with Clinical Chart Validation
Learn how Cotiviti's new cross-claim clinical review feature adds incremental value and can speed the DRG review process without sacrificing accuracy.
Read Case Study
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3 key elements of a successful employment verification process
Looking to improve your employment verification process to support better coordination of benefits results? Here are three important elements to consider.
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Section 340B overview: Medicare, Medicaid, covered entities, and more
The 340B Drug Pricing Program enables certain providers to get discounts on specific drugs, but it can be confusing. Here’s an FAQ on 340B.
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Avoid payment errors and increase prospective savings
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Specialty Drugs: Ensuring payment accuracy beyond prior authorizations
While many plans lean on prior authorizations to ease the processing of specialty drug claims, our experts explore more comprehensive options for getting claims paid more accurately—and more quickly.
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Understanding the 2022 CPT code changes %% Watch the on-demand webinar
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Dental claim review expertise nets significant savings with minimal abrasion for large dental payer
Learn how one payer partners with Cotiviti to augment the capabilities of its own dental reviewers and internal claim editing system with prepay, post-adjudication dental claims review.
Read Fact Sheet
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3 reasons retrospective solutions are a vital part of claims payment integrity
Learn why the foundational value of retrospective solutions makes them a vital part of any successful enterprise payment integrity program.
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A proven approach to preventing E&M over-coding
Cotiviti Chief Medical Officer Richard Pozen, M.D., explains how payers can tackle challenging Level 4 and 5 E&M claims while still paying claims promptly and minimizing abrasion.
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Execute healthcare claims editing more accurately—with less provider abrasion
Payers should consider several best practices when deploying a claim editing solution that pays claims with the highest accuracy and the lowest provider abrasion.
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Prioritizing prepayment integrity savings strengthens health plan's competitive position
Read our Savings Spotlight and learn how one health plan with just under 100,000 members achieved a 3.9% annual prepay savings rate with Cotiviti in 2020.
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Research: Optimizing payment integrity with enterprise pre and postpayment solutions
Cotiviti surveyed health plan leaders to investigate the challenges their organizations are facing with balancing prospective and retrospective payment integrity programs.
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Layered approach delivers pre and postpay savings for mid-sized health plan
Read our Savings Spotlight and learn how one mid-sized health plan saved nearly $20 million in 2020 with Cotiviti's pre and postpay solutions.
Read Fact Sheet
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Podcast: Cotiviti CEO Emad Rizk, M.D. on payment integrity and interoperability
Cotiviti CEO Emad Rizk, M.D., joins The Incrementalist podcast for a conversation on how to turn healthcare waste into better patient care.
Listen to Podcast
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COB in context: Considering the member lifecycle
Break out of hyper-focusing on the claim payment lifecycle and analyze claims within the context of the human experience to optimize your coordination of benefits processes.
View Infographic
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Strategic focus on prepayment claim accuracy leads to nearly $100M in savings for one Blue Plan
Read our Savings Spotlight and learn how one regional Blue Plan serving more than 4 million members achieved nearly $100 million in savings with Cotiviti's prospective payment integrity solutions.
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Keeping members in mind: Optimizing coordination of benefits
Coordination of benefits (COB) requires health plans to navigate significant complexities. The order of benefit determination rules rely on an ever-changing member landscape that is as...
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