Today’s claim editing systems can’t analyze all claims with modifiers without slowing down payments to providers and overburdening health plans’ clinical staff. That’s where Cotiviti Clinical Validation comes in.
A unique market offering that adds a last line of defense against costly overpayments and recoveries, Clinical Validation applies advanced clinical and coding algorithms to nationally sourced edits and flags suspect claims that our team of nurses and coding experts review before final adjudication.
Our fact sheet explores how Cotiviti Clinical Validation helps health plans:
- Increase savings on annual claim spend by 1 percent or more
- Increase payment policy compliance and the accuracy of claim payments
- Redistribute valuable clinical and IT resources