CONCURRENT QUALITY

Close quality gaps before claims adjudication

Reduce reliance on supplemental data and surface potential data gaps before adjudication

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CONCURRENT QUALITY BENEFITS

Improve administrative performance in HEDIS and Star Ratings programs

Reduce costs

on downstream supplemental data, sourcing, managing and auditing

Tailor-built

for improved documentation accuracy, not reimbursement

Intercept data gaps and reconcile quickly

Incomplete data weakens both risk capture and quality performance. It also paints an inaccurate picture of overall care—even if care was delivered correctly. Instead of relying on cumbersome supplemental data, Concurrent Quality closes HEDIS and Star Ratings measure data gaps at the claim level using existing claims workflows. Our proprietary technology reviews claims before adjudication and flags claims with potential data gaps, allowing reconciliation with the provider before it moves on to the standard payer adjudication process.

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129M

member lives reported to NCQA by Cotiviti in MY 2025

Discover the value of Itemized Bill Review

Build quality efforts confidently with real-time visibility into member health.

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Configure to the needs and tendencies of the provider network

Control which measures, codes, providers, and conditions are included, and how frequently providers receive messages.

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Reduce downstream quality costs

Reduce reliance on inefficient and expensive supplemental data sourcing, management, and auditing required downstream.

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Leverage existing claims workflows

Close gaps within existing claims workflows and touchpoints with no required EMR integration.

close-gaps

Close risk and quality gaps together

Run Concurrent Quality in parallel with Concurrent Risk Adjustment to address potential risk and quality data gaps simultaneously.

Quality expertise

Catch data gaps at the source with 
a trusted partner

Backed by decades of quality expertise and NCQA-certified measure logic, Cotiviti helps plans manage everything that happens after the point of care. Concurrent Quality complements Cotiviti’s proven HEDIS and Star Ratings capabilities by helping plans improve data collection and supporting faster gap closure while keeping configuration and program governance under control.

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