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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, improve overall healthcare value, and engage consumers to drive meaningful action.

Payment-Accuracy-loop

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 pre and postpay 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-loop

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-loop

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 provider networks, with members, and with other functional teams within the plan itself to successfully manage members’ clinical and financial risks.

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05_Pop-Health

Population Health Management

Our Population Health Management solutions move members to take meaningful action using a highly tailored, multi-channel approach rooted in empathy. Combining technology with the proper data and analytics as well as a clear user experience, our solutions are built to augment and improve, making it easy to implement and to scale.

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Services

Cotiviti-Retail-loop

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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