Continuous Learning and Improvement
Our healthcare system is constantly evolving, and the past few years have seen an acceleration of that trend with an even greater impact on healthcare payers. Complexity is on the rise, creating new challenges for operations, cost management and competitiveness.
Cotiviti is acting today to enable our clients to thrive in this new world.
We believe that increasing regulatory oversight, a changing competitive landscape, a tighter economic environment and increasing consumer engagement will combine to place greater emphasis on payment accuracy. A payer’s ability to get payments right the first time will become a competitive advantage. That means getting out ahead of issues like improper coding, documentation, and compliance with policies and agreements.
Cotiviti’s vision for the future is to leverage the power of data and analytics across the payment continuum, learning from all that takes place before and after the payment, and using those insights to drive continuous improvement throughout the payer’s operations.
This vision is grounded in a simple principle. The more comprehensively accuracy can be achieved with the right action at the right point along the payment continuum, driven by the right analysis of all the supporting data, the greater the positive impact.
Approaching payment accuracy in this way creates cascading benefits – a feedback loop, in which every insight creates an advancement that enhances results. Payers minimize costs and maximize efficiency. Healthcare providers are less likely to have claims adjusted or rejected. Plan members are less likely to encounter incorrect billing that requires their time and attention to rectify.
It relies on one of the payer’s most valuable assets: data. Every process, from care delivery and network usage, to claim adjudication and edit, to chart validation, audit and reconciliation produces information. It’s the ability to take that endless stream of data, continuously unlock the value hidden in it, and improve accuracy in every way that sets our direction for the future.