How is Cotiviti enabling health plans to navigate new frontiers in payment integrity and fraud, waste, and abuse? Watch our recent video from the 2024 Cotiviti Client Conference (CCC24) featuring Erin Rutzler, vice president of FWA. ▶️ Stay tuned as our video series continues next week with a deep dive into member engagement!
About us
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, consumer engagement, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.
- Website
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http://www.cotiviti.com
External link for Cotiviti
- Industry
- IT Services and IT Consulting
- Company size
- 5,001-10,000 employees
- Headquarters
- South Jordan, UT
- Type
- Public Company
- Specialties
- Analytics, Payment Integrity, Payer Liability, Payment Accuracy, Clinical Appropriateness, Coding Compliance, Contract Compliance, Procure-to-Pay, Supplier Audit, Overpayment Recovery, Healthcare, Retail, Pay-for-Value, HEDIS, Risk Adjustment, and Provider Network Performance
Locations
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Primary
10701 S River Front Pkwy, Unit 200
Unit 200
South Jordan, UT 84095, US
Employees at Cotiviti
Updates
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Even though the COVID-19 Public Health Emergency (PHE) ended a year ago, 26% of Medicaid renewals have not yet been processed. Key steps to help ensure your population remains informed during and beyond the ongoing renewal process include prioritizing preventive care reminders, engaging dual-eligible populations, and conducting SDoH assessments. Learn more from Cotiviti's Leah Dewey, vice president of clinical and consumer engagement operations. https://bit.ly/3X3dMpI #HealthPlans #healthcare
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A comprehensive approach to fraud, waste, and abuse management is critical. Watch our webinar on YouTube and explore the integration of prepay and postpay interventions, with a case study on genetic testing and behavioral health services. Subscribe to our YouTube channel for ongoing insights into FWA and payment integrity. https://bit.ly/3Rc83L7 #FWA #HealthPlans
Program Integrity Pulse: A Claim Pattern Review case study
https://www.youtube.com/
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In our latest LinkedIn newsletter: As health plans experience an increase in medical loss ratio (MLR) due to numerous factors, Michael Jablon offers three strategies to improve outcomes while controlling inappropriate spending. 📰
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Explore the role of AI in payment integrity with Cotiviti’s Brett Arnold and Anandhi Periyanan in our latest podcast episode. They discuss how healthcare payers can use AI responsibly to enhance payment integrity value while improving both the member and provider experience Listen now to gain insights on practical AI applications, the challenges faced by healthcare payers, and how to separate fact from fluff when evaluating AI partners. https://bit.ly/4dwQf5N #payments #HealthPlans #healthcare
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The healthcare industry is at a crossroads, with AI and virtual care emerging as transformative tools. However, opinions vary on the best approach. Some leaders advocate for small, incremental changes and cultural shifts, while others argue for a radical redesign to tackle complex issues. https://bit.ly/3VKSESR HealthLeaders #healthcare #HealthPlans #payments
Is Healthcare on the Right Path to Transformation?
healthleadersmedia.com
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Watch: Cotiviti's Samantha Davis breaks down confirmed measure updates for next year's #HEDIS season. Learn more from our recent on-demand webinar as we offer strategies to effectively prepare for MY 2024 👉 https://hubs.ly/Q02HHzCc0
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Learn about the transformative potential of clinical data exchange in healthcare. Cotiviti's Katie Devlin, DHSc, MS, CPHIMS, vice president of interoperability, explains the Trusted Exchange Framework and Common Agreement (TEFCA) influence on the healthcare industry and how payers can work with QHINs to optimize data exchange. Read her new article in the Journal of AHIMA. https://bit.ly/44PhJjD #HealthPayers #interoperability #payments
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CMS announced it will recalculate the 2024 Medicare Advantage Star Ratings for quality bonus payments following two court rulings in favor of insurers. The new methodology will use the 2023 cut points for recalculations, ensuring consistent treatment across all contracts. https://bit.ly/3RR1VYv Healthcare Finance News Centers for Medicare & Medicaid Services #healthcare #HealthPlans #payments
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While upcoding is the most common "creative billing" scheme for behavioral health, many other schemes are gaining ground. These include: 🔹 Cloning records and boilerplate billing. 🔹 Inappropriate billing of applied behavioral analysis (ABA) therapy. 🔹 Billing impossible days. Discover what's new from Cotiviti's Erin Rutzler, our Vice President of Fraud, Waste and Abuse. https://bit.ly/3XHITrl MedCity News #FWA #MentalHealth #telehealth
Mental Health Fraud Schemes: How to Protect Your Plan - MedCity News
https://medcitynews.com