Solutions

Unlock unique value with Cotiviti

As U.S. healthcare adapts to the rising cost of care, our clients face increasingly complex clinical and financial risk. At Cotiviti, the acuity and dimension of our insights unlock unique opportunities to optimize financial performance, reduce inefficiency, and improve overall healthcare value.

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Payment Accuracy

Our Payment Accuracy suite can unlock previously unrealized medical and administrative cost savings for healthcare payers by providing solutions for every critical dimension along the claim payment lifecycle—from early payment policy management and clinical claim review to post-pay chart review and fraud pattern investigation. We help clients work more effectively across their payment accuracy silos by deploying the right approach at the right time, driven by a full-service model and the deepest industry expertise.

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Risk Adjustment

Our Risk Adjustment suite includes complete prospective and retrospective risk adjustment solutions supported by technology, analytics, artificial intelligence, and deep subject-matter expertise. We are committed to ensuring that plans are appropriately reimbursed to manage and coordinate care for their members.

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Quality and Performance

Our Quality and Performance suite allows health plans to move from simply reporting quality measures to driving the purchase, delivery, and utilization of higher value healthcare. Our solutions enable health plans to collaborate more effectively with their providers networks, with members, and with other functional teams within the plan itself to successfully manage members’ clinical and financial risks.

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Cotiviti Retail

Cotiviti Retail solutions provide audit and recovery services for all retail verticals, including mass merchandisers, grocery and discount chains, department stores, and specialty retailers. Every year across our client base, we help the largest and most influential retailers in the industry save hundreds of millions of dollars.

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Services

  • Merchandise Payables
  • Pharmacy
  • Freight
  • Activations
  • Statements
  • Contract Compliance
  • Expense Payables
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Cotiviti Life and Legal

Cotiviti Life and Legal solutions enable law firms, life insurance providers, and workers’ compensation fund organizations to quickly retrieve medical information. Our patented technology and exceptional team of experts help reduce retrieval times, eliminate errors, and lower costs.

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Quality and Performance solutions

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Payment Accuracy solutions

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Risk Adjustment solutions

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