Ensure Claim Accuracy

Efficiently correct inappropriate coding while
validating other suspect claims

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Claim Accuracy solutions are part of Cotiviti's
Payment Accuracy solution suite.

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Healthcare payers are under immense pressure to deliver the best possible member experience while reducing medical loss ratio (MLR) to help ensure their long-term sustainability. But frequently shifting payment policies, contracts, regulations, and more make it all-too-easy for inappropriate claims to slip through the cracks and get paid, driving up waste and increasing costs for everyone involved.

Cotiviti helps ensure pre and postpay claim accuracy by efficiently correcting inappropriate claim coding while validating other suspect claims against medical records, contract terms, and other data.

With our Payment Policy Management solution as the enabling technology, Cotiviti can ingest multiple data feeds just once for use throughout our Payment Accuracy solutions, including:

  • Real-time and historical claims
  • Member eligibility
  • Fee schedules
  • Provider contracts

Dive deep into Cotiviti's Claim Accuracy solutions

Learn more about our industry-leading solutions that deliver pre and postpay claim accuracy, eliminating both simple and complex errors while reducing improper payments by billions of dollars per year across our payer clients.

Payment Policy Management

Identify improper claims before payment

Coding Validation

Reduce costs from clinically complex claims

Clinical Chart Validation

Find more value from clinical review and validation

Data Mining and Contract Compliance

Identify and recover complex billing and payment errors

Dental Claim Accuracy

Identify suspect claims early and improve prepay dental claim integrity

 

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