Cotiviti will introduce 360 Pattern Review at the 2024 NHCAA Annual Training Conference, delivering true end-to-end FWA prevention and management to payers.

Cotiviti Blog

14.11.2024

Busted: The top fraud schemes of Q3 2024

Physician fraud, genetic testing fraud, and fraudulent DME billing made up some of the most notable FWA cases in the third quarter of 2024.

Cotiviti Blog

07.11.2024

Case study: Highmark Wholecare prevents FWA with Claim Pattern Review

Learn how Cotiviti’s prepay FWA solution Claim Pattern Review helped a small SIU to achieve better payment integrity.

Cotiviti Blog

31.10.2024

Case study: Engaging members to apply for the Low-Income Subsidy (LIS)

Learn how one large Medicare Advantage plan successfully helped its members retain critical low-income benefits.

Cotiviti Blog

29.10.2024

3 takeaways for Medicare Advantage plans from the 2025 Star Ratings

As Medicare Advantage plans continue to see their Star Ratings decline, here are three takeaways from the newly released 2025 Star Ratings.

Cotiviti Blog

25.10.2024

Webinar: What TPAs need to know about payment integrity

Learn why TPAs that do not offer prepay integrity services risk losing their competitive advantage.

Cotiviti Blog

18.10.2024

Proactive member engagement strategies to close gaps in Medicare Advantage

Learn tips to prepare for the Annual Election Period and upcoming CMS changes.

Cotiviti Blog

17.10.2024

Webinar: Key updates to improve coding accuracy in 2025

Cotiviti Blog

09.10.2024

Webinar: Decoding the 2025 Star Ratings

Attend our webinar and learn key takeaways from the latest Star Ratings with Cotiviti.

Cotiviti Blog

01.10.2024

Partnering for success in 3 critical areas of risk adjustment

Discover best practices to improve your risk adjustment program and strengthen results and compliance.

Cotiviti Blog

26.09.2024

Decoding the HEDIS MY 2025 Technical Specifications

Here's what you need to know for HEDIS Measurement Year (MY) 2025, including measure retirements, new measures, and changes to existing measures.

Cotiviti Blog

24.09.2024

Webinar: Lessons learned from a successful prepay FWA program

Protect your plan from FWA with tips from our latest webinar featuring Highmark Wholecare.

Cotiviti Blog

17.09.2024

Recovering improper costs in SNF and IRF claims

Learn how to untangle the complexity of skilled nursing facility (SNF) and impatient rehab facility (IRF) claims.

Cotiviti Blog

12.09.2024

eBook: How AI can drive health plan success

See how AI can drive additional value and improve results for health plans without replacing human expertise.

Cotiviti Blog

04.09.2024

4 attributes of a successful specialty drug payment integrity program

Read Cotiviti’s white paper to learn how a multifaceted pre and postpay approach can ease the verification of specialty drug claims.

Cotiviti Blog

30.08.2024

Webinar: Engaging with members at the end of the year

Learn how to improve member engagement and retention as we head into the last quarter of 2024.

Cotiviti Blog

27.08.2024

eBook: The three pillars of coordination of benefits (COB) success

Optimize your COB program with Cotiviti’s proven approach.

Cotiviti Blog

23.08.2024

Podcast: Star Ratings strategies for smaller MA plans

Cotiviti joins AJMC's Managed Care Cast to discuss strategies smaller Medicare Advantage plans can adopt to improve Star Ratings.

Cotiviti Blog

21.08.2024

Webinar: Decoding the HEDIS MY 2025 Technical Specifications

Join us for the fifth installment of our Quality Decoded series as we break down the latest HEDIS changes published by NCQA.

Cotiviti Blog

16.08.2024

Busted: The top fraud schemes of Q2 2024

Read a rundown of notable healthcare fraud, waste, and abuse cases from April through June 2024.

Cotiviti Blog

09.08.2024

FWA Insights: Catching outlier behaviors in physical therapy claims

Learn how Cotiviti’s SIU identified a physical therapy outlier and discovered patterns of inappropriate billing.

Cotiviti Blog

07.08.2024

Webinar: Integrating internal and external risk adjustment innovations

Learn how health plans can combine internal and vendor resources to strengthen results and compliance.

Cotiviti Blog

02.08.2024

Checklist: How to build a valuable coordination of benefits program

Read Cotiviti’s newest checklist as we share how to streamline coordination of benefits and improve payment integrity results.

Cotiviti Blog

31.07.2024

Navigating new frontiers in interoperability

Discover insights from Cotiviti on overcoming challenges in healthcare interoperability and data exchange in the digital age.

Cotiviti Blog

30.07.2024

Podcast: Deploying AI in payment integrity responsibly

Listen to the Payment Integrity Insights podcast as we discuss Cotiviti’s four core principles for artificial intelligence.

Cotiviti Blog

26.07.2024

10 tips for a successful commercial risk adjustment program

Learn how to enhance coding accuracy, retrieval rates, and overall commercial risk adjustment program results.

Cotiviti Blog

24.07.2024

Navigating new frontiers in member engagmeent

Discover how Cotiviti is enabling health plans to navigate challenges such as Medicaid redetermination and health equity to drive better member outcomes.

Cotiviti Blog

23.07.2024

Podcast: Artificial intelligence in payment integrity

Listen to the Payment Integrity Insights podcast as we discuss how to deploy AI responsibly in payment integrity to improve results.

Cotiviti Blog

20.07.2024

Navigating new frontiers in payment integrity

Cotiviti's Erin Rutzler, vice president of fraud, waste, and abuse, explains how Cotiviti is empowering health plans to navigate new frontiers in payment integrity.

Cotiviti Blog

10.07.2024

Navigating new frontiers in risk adjustment

Cotiviti's Katie Sender, vice president of clinical and coding services, explains how Cotiviti is helping payers navigate to better risk adjustment outcomes.

Cotiviti Blog

04.07.2024

Quality Decoded webinar: Preparing for HEDIS MY 2024

Join Cotiviti’s webinar on July 18 as we unpack the results of MY 2023 and offer strategies for next season.

Cotiviti Blog

03.07.2024

Navigating new frontiers in quality improvement

Cotiviti's Branka Sustic, vice president of quality and risk adjustment, explains how Cotiviti enables health plans to navigate the changing quality improvement landscape.

Cotiviti Blog

25.06.2024

What to expect from CMS recalculating Star Ratings

Learn the latest changes to Star Ratings due to the SCAN ruling and their impact for 2025.

Cotiviti Blog

20.06.2024

Webinar: Provider billing accuracy and payment trends

Gain insight from Cotiviti’s broad claims dataset as we highlight important medical cost trends and identify new payment policy opportunities.

Cotiviti Blog

18.06.2024

3 strategies for payers to curb increasing medical loss ratios

Discover key areas that can decrease medical loss ratio.

Cotiviti Blog

14.06.2024

White paper: Getting self-insured employer groups on board with payment integrity

Read Cotiviti’s white paper to learn how plans can extend improved payment accuracy and savings to ASO partners.

home›Cotiviti Blog›Health

Cotiviti Blog - Health

White Paper: Enhancing dental payment accuracy to combat FWA

Webinar: Advancing beyond traditional FWA lead detection

Case study: Benefits administrator achieves millions in payment integrity value

Podcast: Driving lasting impact through interoperability

Realizing the evolution of FWA prevention and management

Busted: The top fraud schemes of Q3 2024

Case study: Highmark Wholecare prevents FWA with Claim Pattern Review

Case study: Engaging members to apply for the Low-Income Subsidy (LIS)

3 takeaways for Medicare Advantage plans from the 2025 Star Ratings

Webinar: What TPAs need to know about payment integrity

Proactive member engagement strategies to close gaps in Medicare Advantage

Webinar: Key updates to improve coding accuracy in 2025

Webinar: Decoding the 2025 Star Ratings

Partnering for success in 3 critical areas of risk adjustment

Decoding the HEDIS MY 2025 Technical Specifications

Webinar: Lessons learned from a successful prepay FWA program

Recovering improper costs in SNF and IRF claims

eBook: How AI can drive health plan success

4 attributes of a successful specialty drug payment integrity program

Webinar: Engaging with members at the end of the year

eBook: The three pillars of coordination of benefits (COB) success

Podcast: Star Ratings strategies for smaller MA plans

Webinar: Decoding the HEDIS MY 2025 Technical Specifications

Busted: The top fraud schemes of Q2 2024

FWA Insights: Catching outlier behaviors in physical therapy claims

Webinar: Integrating internal and external risk adjustment innovations

Checklist: How to build a valuable coordination of benefits program

Navigating new frontiers in interoperability

Podcast: Deploying AI in payment integrity responsibly

10 tips for a successful commercial risk adjustment program

Navigating new frontiers in member engagmeent

Podcast: Artificial intelligence in payment integrity

Navigating new frontiers in payment integrity

Navigating new frontiers in risk adjustment

Quality Decoded webinar: Preparing for HEDIS MY 2024

Navigating new frontiers in quality improvement

What to expect from CMS recalculating Star Ratings

Webinar: Provider billing accuracy and payment trends

3 strategies for payers to curb increasing medical loss ratios

White paper: Getting self-insured employer groups on board with payment integrity

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