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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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Not all overpayments can be remediated before payment. While health plans strive to pay claims correctly the first time, various obstacles create challenges that can result in overpayment. When incorrect payments to providers do occur, health plans need strong analytics and pinpoint research to aid answers for recovery—without impacting critical provider relationships. 
Just like getting safe drinking water to your tap, payment integrity requires a number of filtering and purification steps to produce the most precise payments possible. Our new infographic dives into how Data Mining works and offers key takeaways for health plans to catch similar post-payment findings. You’ll learn about:  

  • Plan policies and coding standards that result in payment integrity challenges 
  • Best practices to identify post-payment errors 
  • How payers can address inappropriate claims like these 

About the Author

As senior vice president of implementation, recovery, and technology, Susan is responsible for many functions across several of Cotiviti's payment integrity solutions, including Coordination of Benefits (COB) Validation, Clinical Chart Validation, and Data Mining. She is a visionary executive with extensive experience in account management and sales leadership, call centers and call center technologies, organizational design, quality, directing and leading operations and technology organizations.

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