Learn the critical elements of creating a positive member experience from the outset for Medicare Advantage plans, beginning with building trust with the power of multi-channel communications.
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Discover how the pandemic has affected behavioral health claims and learn different tactics for avoiding fraud, waste, and abuse.
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Learn how Medicaid plans can support whole-person, culturally competent, and equitable care—from enrollment to renewal.
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While many plans lean on prior authorizations to ease the processing of specialty drug claims, our experts explore more comprehensive options for getting claims paid more accurately—and more quickly.
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Updated in 2022 for DxCG's 25th anniversary, this is the story of the birth and evolution of one of the earliest and most accurate risk assessment and predictive modeling solutions in the industry.
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Cotiviti Chief Medical Officer Richard Pozen, M.D., explains how payers can tackle challenging Level 4 and 5 E&M claims while still paying claims promptly and minimizing abrasion.
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Cotiviti surveyed health plan leaders to investigate the challenges their organizations are facing with balancing prospective and retrospective payment integrity programs.
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Payers continue to invest in innovative techniques to prevent improper payments, rather than “pay and chase." Learn how health plans can successfully navigate the challenges of prospective validation.
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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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