Calculate your Cotiviti risk adjustment opportunity
What results could you be achieving with Cotiviti for your Medicare risk adjustment programs? Use this calculator and find out!
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Commercial and Medicare Risk Adjustment
Improve your prospective and retrospective risk adjustment results with these resources from Cotiviti, including white papers and articles written by our senior risk adjustment experts.
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Prospective Risk Adjustment: Clinical data that drives revenue and strategy
One solution for proactively re-engaging members with the healthcare delivery system and accurately documenting disease burden is In-Home Assessments (IHAs). Learn how to optimize them in our webinar.
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Q&A: Strategic payer initiatives at the intersection of risk and quality
By working in unison, risk adjustment and quality teams can better understand where care gaps exist and the most effective ways to deliver high-value care to disengaged or disenfranchised members.
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How to turn in-home assessments into “close encounters of the right kind”
Health plans complete in-home health assessments (often called health risk assessments) for their members for several reasons: accurately documenting members’ risk burden, supporting...
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The three fundamentals of risk adjustment success
Risk adjustment—and the complex nature of the processes involved—is often misunderstood. Learn the fundamentals health plans must master to be successful.
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Mitigating the impact of COVID-19 on risk adjustment and quality scores
As routine medical services are cancelled or postponed due to COVID-19, prospective risk scores used to pay Medicare Advantage (MA) health plans in 2021 are trending lower than...
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10 tips for a seamless commercial risk adjustment program
Learn best practices to optimizing commercial risk adjustment revenues while maintaining total compliance.
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CMS 2022 Advance Notice: 4 key takeaways for MA plans
The public comment period has just closed for the calendar year (CY) 2022 Medicare Advantage (MA) and Part D Advance Notice recently released by the Centers for Medicare & Medicaid...
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Decoding the 2021 CPT code changes
Cotiviti's experts break down the >300 changes to the 2021 CPT code set, including a major overhaul to office and other outpatient E&M services.
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The evolution of DxCG, the gold standard in risk adjustment and predictive modeling
This is the story of the birth and evolution of DxCG, one of the earliest and most accurate risk adjustment and predictive modeling solutions in the industry.
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CMS releases ACA risk adjustment transfer payments and HRADV adjustments for 2019
The Centers for Medicare & Medicaid Services (CMS) recently released the health plan-specific 2019 benefit year risk adjustment transfer payments. As part of the Affordable Care Act...
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Risk Adjustment solutions
Ensure compliant, accurate compensation for the risk burden of your members
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Prospective Risk Adjustment solution
Accurately document disease burden and close care gaps
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Suspect Analytics solution
Effectively identify members with suspected but potentially undocumented conditions
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In-Home Assessments solution
Ensure member conditions are accurately documented and coded to optimize plan revenues while closing care gaps
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Medical Record Retrieval solution
Improve risk adjustment and HEDIS® results while minimizing provider disruption
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Medical Record Coding solution
Accurately capture and document risk-adjustable conditions
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Risk Adjustment Submissions solution
Improve risk adjustment submission rates
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