Cotiviti Clinical Appropriateness Policy Collection
Learn how PPM clients can prevent payment of improper claims based on clinical appropriateness guidelines by assessing unused policy and deploying missing decision points.
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Learn how PPM clients can prevent payment of improper claims based on clinical appropriateness guidelines by assessing unused policy and deploying missing decision points.
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Learn about our new policy collection, which bundles all COVID-related decision points across the PPM content library for easier policy review.
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Learn about our compilation of existing, enhanced, and net new inpatient claim policies developed and deployed in PPM and Coding Validation.
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Learn how our new policy collections comprise >3,000 decision points organized into 13 specific areas of D&B logic.
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Learn how to conduct telehealth policy review more easily while preventing improper payments
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Learn how to prevent payment of thousands—even millions—of dollars in overpaid multiple endoscopy procedure claims by applying actual reduction amounts during editing versus a flat 50%.
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Cotiviti, in partnership with InformedDNA, has applied 10+ years of genetic testing experience working with millions of claims to build proprietary test identification logic.
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E&M clients successfully navigate organizational sign-off, provider abrasion, compliance concerns and state health insurance inquiries when using our policy.
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Learn how our policy assesses the resources the hospital used on ER facility Level 4 and 5 E&M claims and renders a decision at the appropriate level.
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