About Cotiviti

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.

  • 200+payer clients, including all top 25 national health plans
  • ~150Munique lives represented in
    claims datasets
  • Top 25health plans as clients
  • ~$10Bin identified and corrected medical spend annually through Payment Integrity (prepayment and postpayment)
  • +1–2%savings rate across our full
    prepayment solution
Our Work

What we do

Cotiviti works with more than 200 healthcare payers and health systems, including all of the top 25 plans in the United States, to deliver higher-performing payment accuracy, risk adjustment, quality improvement, and consumer engagement programs. We take in billions of clinical and financial data points, analyze them, and help our clients discover ways they can improve the efficiency and the quality of care.

In doing so, we focus on preventing erroneous payments that drive up costs, helping plans maximize quality efforts, and supporting payer and provider risk adjustment programs for accurate compensation. In addition, Cotiviti supports the retail industry with audit and recovery services in order to increase their efficiency and ensure alignment on strategy and resource allocation.

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Through our partnership with health plans, Cotiviti helps members protect their benefits by working to ensure:

  • Their healthcare bills are paid appropriately and free of fraud, waste, and abuse
  • They’re receiving the appropriate quality of care in line with regulatory and industry standards
  • They are appropriately covered by their health plans
The Stakes

Why it matters

Our differentiated software and solutions elevate the quality of care, tackling what Cotiviti estimates as $12 billion of inefficiency and waste in the system. We strive to unlock unique opportunities for health plans and at-risk providers to solve this persistent challenge by reducing inefficiency, closing care gaps, improving scale, helping ensure claims are appropriately reimbursed, and engaging members with the right message at the right time.

By the Numbers

What we deliver

$10B+ in payment errors avoided or corrected annually
129M+ HEDIS® lives reported through our quality solutions
$2B+ in appropriate incremental risk adjustment revenue across Medicare Advantage clients
Purpose

Our vision and mission

We envision a healthcare system that functions with greater coordination, efficiency, and trust. To get there, our mission is to enable healthcare to function as a coordinated system by providing the financial infrastructure that connects and governs it, so that the entire ecosystem operates with greater efficiency and trust.

Advanced technology

Our dynamic, integrated SaaS solutions deliver speed and precision across payment integrity, risk adjustment, quality improvement, and member engagement programs while minimizing internal resource burden.

Data analytics

Our unique data and analytics ecosystem enables our clients to maximize the insights derived from both their financial and clinical data to drive better care at lower cost.

Specialized expertise

Our specialized and talented teams work in tandem to help ensure operational efficiency across our enterprise and that our services are delivered with high accuracy, exceeding industry standards.

The Way We Work

The way we work is as important as the work we do. Guided by our values — People Obsessed, Build Better, Deeply Curious, and Make It Count — we challenge ourselves to put people first, continuously improve, ask better questions, and deliver meaningful outcomes. These principles shape how we innovate, collaborate, and create lasting value for our customers.

  • People obsessed icon People Obsessed
  • Build better icon Build Better
  • Deeply Curious icon Deeply Curious
  • Make It Count icon Make It Count
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Corporate social responsibility

Through Cotiviti Cares, we not only embrace our corporate values, but hold ourselves accountable to respect and improve our planet—and build a better world for its people.

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Associations and certifications

We are committed to the privacy and security of your data and participating in partnerships that improve our healthcare system.

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