Large Medicaid payer protects taxpayer dollars, financial integrity with prepay review
Learn why one large Medicaid plan realizes value from Cotiviti's prepay solutions and differentiated service model.
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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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Bridging care gaps and improving access for rural members
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Optimizing payment integrity for emergency department E/M claims
Learn three key trends shaping emergency department (ED) E/M claims as we examine their impact on payers and payment integrity programs.
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Everest Group names Cotiviti the highest-designated Leader in Payment Integrity%%Read the Payment Integrity Solutions PEAK Matrix® Assessment 2025
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Medical pharmacy data mining innovation uncovers significant findings for large national plan
Learn how a multi-state managed care organization identifies complex pharmacy errors and more with Cotiviti’s solutions.
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Payment integrity: Unlocking the value of complex outpatient reviews
Learn about one of the most impactful and often underutilized tools in a high-performing payment integrity program: the complex outpatient review.
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Prepay coordination of benefits (COB) boosts payment integrity results for large national payer
Learn how health plans can prevent overpayments, reduce future erroneous payments, and confirm that primary payment responsibility is correctly assigned—all while lowering provider abrasion.
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Unparalleled analytics inform key payment integrity decisions for large payer
Discover how cross-payer analytics drove payment integrity success for one of Cotiviti's health plan clients.
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Payment Integrity Pulse: 2025 regulatory and market changes
Learn more about the impact of CPT code changes in E/M, the shift from inpatient to outpatient utilization, and more.
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Regional Blue Plan performs beyond expectations with Data Mining
Learn how Cotiviti helped deliver a significant increase in overpayment recoveries through data mining expertise.
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Prioritizing prepay integrity strengthens mid-sized health plan's competitive position
Learn how one mid-sized health plan uses prepay claim editing to improve its competitive position.
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The fundamentals of payment integrity for TPAs
Learn crucial strategies for TPAs to deliver effective payment integrity programs for their self-funded clients.
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Prepay claims editing improves payment accuracy for self-funded employers
Learn how Cotiviti helped one benefit administrator prevent $28M in inappropriate payments for clients.
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Prepay integrity: What the self-insurance industry needs to know
Learn how TPAs can deliver a high-performing payment integrity program to their plan sponsor clients—and why it matters more than ever.
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Recovering improper costs in SNF and IRF claims
Learn how to untangle the complexity of skilled nursing facility (SNF) and impatient rehab facility (IRF) claims.
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Health plan finds new value with AI-enabled clinical reviews
See how the safe application of AI can drive additional value and improve health plan results—without replacing human expertise.
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eBook: The evolving role of artificial intelligence in payment integrity
Learn how to deploy AI responsibly in your payment integrity program—and separate fact from fluff when evaluating vendors.
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3 strategies for payers to curb increasing medical loss ratios
Discover key strategies that can decrease MLR for payers as medical costs continue to rise.
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eBook: The three pillars of coordination of benefits (COB) success for health plans
Learn the importance of accurate data, advanced analytics, and specialized expertise to execute a high-functioning, end-to-end coordination of benefits (COB) program.
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The payment integrity guide for health plans
Read this guide as we break down the fundamental strategies behind implementing a comprehensive, end-to-end approach to payment integrity for commercial, Medicare Advantage, and Medicaid health plans.
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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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7 steps to build a valuable coordination of benefits program
Read our new checklist to learn how to execute data enrichment, focus on the claims most likely to yield a finding, and more.
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