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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The COVID-19 pandemic has led to unprecedented challenges for Medicaid plans. Here are five areas that Medicaid plans should evaluate to protect their business in this environment.
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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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