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 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 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.
Through our partnership with health plans, Cotiviti helps members to 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
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.
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.
in payment errors avoided or corrected annually
HEDIS® lives reported through our quality solutions
in appropriate incremental risk adjustment revenue across Medicare Advantage clients
Our vision is to enable a high-quality and viable healthcare system. Our mission is to improve the healthcare system through our combination of advanced technology, data analytics, and specialized expertise. Click the tiles below to learn more.
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.
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.
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.
At Cotiviti, we pledge to drive exceptional value for our clients through the depth of our insights, our comprehensive portfolio of healthcare solutions, and our 25+ years of experience optimizing the results we deliver. We pledge to:
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).