Post-pandemic telehealth: Catching FWA in behavioral health claims
Discover how the pandemic has affected behavioral health claims and learn different tactics for avoiding fraud, waste, and abuse.
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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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Ensuring accuracy of specialty drug claims %% Watch our on-demand webinar
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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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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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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.
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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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Moving beyond prepay vs. postpay to an enterprise payment integrity strategy
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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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The right payment integrity intervention at the right time %% Watch the on-demand webinar featuring our payment integrity leaders
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Understanding the 2022 CPT code changes %% Watch the on-demand webinar
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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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Avoid payment errors and increase prospective savings
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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.
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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.
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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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Transitioning from postpayment recovery to prospective validation
Payers continue to invest in innovative techniques to prevent improper payments, rather than “pay and chase." Learn how health plans can successfully navigate the challenges of prospective validation.
Read White Paper
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Reduce FWA in 2021 with a proactive approach
Cotiviti's senior leaders explain how to guard against healthcare fraud in 2021 amid recent CPT code updates coupled with permanent regulatory changes to telehealth.
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Podcast: A better approach to clinical appropriateness in claims payment
Listen to our podcast and learn how to ensure that claims are clinically appropriate through a combination of coordinated technology and human review.
Listen to Podcast
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Be certain about your payment integrity partner
Learn the steps you can take to maximize savings by thoughtfully deploying Cotiviti’s Payment Accuracy solutions.
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How Medicaid plans can overcome the inevitable strain of COVID-19
The COVID-19 pandemic has led to unprecedented challenges for Medicaid plans. Here are five areas that Medicaid plans should evaluate to protect their business in this environment.
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Beyond claims: how to design a more member-centric COB process
Cotiviti payment leaders explain how to optimize your coordination of benefits (COB) process to account for variable member life events to help ensure proper COB determinations.
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