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Performing more prospective validation of clinical claims

Addressing improper claims before they’re paid is more effective than a “pay-and-chase” approach, which is why Cotiviti is leading the way forward to help health plans move retrospective payment programs to a prospective model.

This video provides a quick overview of two Cotiviti Prospective Accuracy solutions: Coding Validation and our brand new Prospective Clinical Chart Validation. Watch and you'll learn:

  • How Cotiviti’s prospective solutions quickly review professional, outpatient facility, and inpatient claims that have clinical coding too complex for automated editing systems.
  • Why “lower-dollar” inappropriate claims should not be ignored.
  • How our new Prospective Clinical Chart Validation solution provides higher conversion rates, greater provider participation and satisfaction, and shorter chart reviews.

Getting the right prospective solutions in place can mean millions of dollars in savings and less provider abrasion for your health plan.