Commercial, Medicare, and Medicaid lines of business all face unique challenges in a rapidly changing market. The key to success, however, remains constant: smart decisions based on sound data. Whether you want to improve payment accuracy, risk adjustment, care quality, consumer engagement, or network performance, Cotiviti has the most complete set of solutions to meet your needs, backed by decades of experience and our passionate commitment to your success.
Solutions for payers
Government agencies, in
Cotiviti Government Solutions provides multiplatform solutions that drive effective and efficient management and stewardship of mission-critical programs. As a CMS Recovery Audit Contractor (RAC),
Cotiviti is the designated CMS RAC for Regions 2, 3, and 4. Whether you’re new to the RAC program or working with Cotiviti, we have resources to help you.
Solutions for government agencies
Provider organizations have moved steadily into value-based healthcare delivery and payment programs. However, successful risk management is as challenging as it is essential.
Cotiviti’s performance analytics solutions help provider organizations understand and mitigate clinical and financial risks, delivering the insights needed to design and refine high-impact population health strategies. Our track record of success in managing multi-payer claim sets and other clinical data allows accountable care organizations and other risk-bearing providers to create a true longitudinal record across many settings of care to make better, data-driven decisions.
To do what’s right to reinforce employee health, you need to have insights into healthcare cost, quality, and utilization. Cotiviti’s performance analytics solutions help self-insured employers, insurance brokers, and third-party administrators set the right strategy for health and productivity improvement and objectively measure results, ensuring program ROI. We support employers with:
Solutions for employers, brokers, and TPAs
For retailers, financial leakage can occur from a range of channels, including but not limited to overpayments, under-collection of trade funding and vendor income, routing compliance violations, and breakdowns in the returns process. Even if retailers optimize payments and collections with 99.9 percent accuracy, the remaining space can translate to millions of dollars.
Solutions for retailers