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Thanks for joining Cotiviti at
NHCAA's Annual training Conference.

Get answers to your payment accuracy questions

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We had a great time talking about your challenges, what you’re doing to solve them, and how we might be able to help you.

Researching potential payment integrity partners can be time-consuming and tedious, so we thought we’d offer you a one-stop shop explaining how Cotiviti’s solutions can power better outcomes—for you, your providers, and your members.

Your challenges
Our answers

Claims with over-coded E&M’s or misused modifiers slip through your editing system and get paid

Cotiviti’s Clinical Validation solution adds an extra layer of review to automated editing to analyze the most complex claims pre-pay.

  • Expert nurse coders render a payment decision immediately
  • Payment recommendations sourced from nationally recognized coding standards to ensure denials or reductions are defensible
  • Editing and payment guidelines automatically updated by Cotiviti through our SaaS offering

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Your SIU team is understaffed and overburdened

Cotiviti’s FWA Solutions provide end-to-end support for preventing and catching fraud, waste, and abuse.

  • Use in combination or standalone for maximum flexibility
  • Catch FWA both pre-pay and post-pay
  • Includes SIU Services offering investigative support, clinical review, claim verification, and consultation

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Identifying and recovering overpayments requires extensive review of complex contractual terms

Cotiviti’s Contract Compliance solution enhances accuracy in the application of liability, coverage, and payment terms for contracted agreements.

  • Precision analytics leveraged within each client’s payment integrity program deliver innovative overpayment findings yielding higher savings
  • Safeguard contract compliance at every point in the claim payment cycle
  • Stay price competitive while improving member satisfaction with the billing process

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Post-pay chart review is too costly and causes significant provider abrasion

Cotiviti’s Clinical Chart Validation solution is driven by analytics to focus on only those charts most likely to generate value.

  • Isolate charts with the highest probability of overpayment
  • Catch higher-value errors that others miss with coding, documentation, and clinical validation
  • Full-time medical directors lead reviews and appeals conducted by nursing and coding teams with significant credentials and extensive experience

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