Cotiviti, Inc.

The payment integrity playbook for success in 2023 and beyond
Our eBook offers insight into how you can develop a solid foundation in 2023 for holistic payment success across your critical programs by following best practices when deploying a prepay claim editing solution, strategically using postpay data mining for the most complex claims, going beyond prior authorizations for specialty drug claims, and designing a holistic COB process that considers the entire member experience.

Developing trust with Medicare Advantage members through better engagement
Medicare Advantage (MA) plans saturate the market, with 39 plan offerings available to the average Medicare beneficiary. To stay ahead of the competition, plans must focus on member satisfaction and engagement to increase revenue. Our white paper offers key strategies for building trust with MA plan members through multichannel communications.

Star Intelligence fact sheet
Cotiviti's Star Intelligence gives health plans the ability to track, predict, and model their Star Ratings. This empowers plans with the capability to understand and prioritize actions needed to offer better care to a growing MA population and to optimize bonus payments. Many plans may struggle to predict their Star Ratings for the current year and beyond, using homegrown solutions or Stars-specific offerings. But with Star Intelligence, plans can choose to integrate with our Quality Intelligence solution for a more holistic view of members in regards to quality, Star Rating improvement, member engagement, and more.

How Data Mining helps clean up your claim payment stream
While health plans strive to pay claims correctly the first time, various obstacles create challenges that can result in overpayment. Just like getting safe drinking water to your tap, payment integrity requires a number of filtering and purification steps to produce the most precise payments possible. Our new infographic dives into how Data Mining works and offers key takeaways for health plans to catch similar postpayment findings.

Payment Accuracy solutions brochure
Cotiviti's suite of integrated Payment Accuracy solutions identifies previously unrealized medical and administrative cost savings for clients by providing integrated capabilities that can review 100% of all major claim types - both pre and postpay - helping ensure accuracy, determine responsibility, and detect patterns of fraud, waste, and abuse (FWA). Connectivity among these solutions creates a natural feedback loop, applying improvements to the right intervention type at the right time in the claim process.

Quality and Performance solutions brochure
As value-based reimbursement becomes more widely adopted, Cotiviti's Quality and Performance solutions allow health plans to move from simply reporting quality measures to driving the purchase, delivery, and utilization of higher value healthcare. Our solutions enable health plans to collaborate more effectively with their provider networks, with members, and with other functional teams within the plan itself. The result? Plans can successfully manage members' clinical and financial risks, make the most of limited internal resources, and stay compliant with industry requirements and regulations.

Rising telehealth: Catching FWA in behavioral health claims
Cotiviti presents a white paper that examines where weak points exist within behavioral healthcare claim payments and explains how plans can both safeguard themselves and be confident in their claim accuracy.

Close gaps in care with integrated quality improvement and member engagement
Closing care gaps is the key to better member health and improving HEDIS and Star Ratings performance. With so much at stake, health plans need synergy between their quality improvement and member engagement solutions. Read our fact sheet and learn how to realize the full power of Cotiviti's integrated Quality Intelligence, Star Intelligence, and Eliza solutions.

Developing trust with Medicare Advantage members through better engagement
Medicare Advantage (MA) plans saturate the market, with 39 plan offerings available to the average Medicare beneficiary. To stay ahead of the competition, plans must focus on member satisfaction and engagement to increase revenue. Our white paper offers key strategies for building trust with MA plan members through multichannel communications.

eBook: Achieving risk adjustment excellence in the hyper-competitive Medicare Advantage landscape
Cotiviti's eBook shares key strategies to improve your results with premium accuracy, plans need to master the fundamental activities of risk adjustment: suspect analytics, clinical data acquisition, HCC coding, and data submissions. But fundamentals alone won't help plans separate themselves in today's ultra-competitive Medicare Advantage marketplace. Read our eBook to learn more.