As health plan claim volumes grow amid cost increases and changing guidelines, the opportunity for inappropriate claims to slip through the cracks and get paid grows, too. Especially when plans use a siloed and disconnected approach to payment integrity.
Cotiviti's Payment Accuracy suite helps you knock down those silos by shortening time-to-results from more than 90 days to less than five with an integrated pre and postpayment program. And with dynamic solutions that can work together to review 100% of all major claim types at the right intervention point, our clients can flexibly manage their MLR and unlock more incremental savings value, with less burden on provider partners and administrative teams. Watch this short video to learn more.
Payment integrity leadership requires experience, scalability, innovation, and proven value. Cotiviti has spent 20+ years honing our solutions specifically to drive exceptional value for our clients all along the claim payment life cycle.
More savings opportunities
in medical cost savings delivered in 2022*
Faster path to value
days until identification of savings begins**
Greater breadth and depth of analytics
of payment rules, policies, and concepts spanning prospective and retrospective intervention points
A trusted partner
21 of the top 25
national payers are clients, with nearly 100 unique payer clients total
* Based on recent, actual client-accepted savings across our portfolio. Individual organization results will vary based on client acceptance of identified opportunities and policies.
** Some Cotiviti post-pay solutions are able to start identifying savings 8–12 weeks from receipt of a valid data file. Payment Policy Management averages about 150 days for real-time implementation, depending on client resources.
Improve payment integrity and speed-to-value all along the continuum
Identify millions of dollars in prospective payment savings
Reduce costs from clinically complex claims
Reduce the cost of inappropriate dental claims
Identify and validate potentially fraudulent or abusive claims prior to payment
Save 1 to 2 percent of DRG spend with comprehensive medical record review services
Realize 80 percent of overpaid findings as cost savings
Save medical costs by finding undetected billing compliance issues
Recover an average 16 percent more with contract data alone
Detect and deter fraud, waste, and abuse (FWA) for up to 15:1 ROI