Detect and deter fraud, waste, and abuse (FWA) while meeting compliance and financial goals
Discover more in payment integrity
Mandated processing efficiencies, overlooked claims, overwhelmed or insufficient staff, disparate record systems—all create opportunities for fraud, waste, and abuse (FWA). Financial losses due to FWA, both intentional and unintentional, are estimated to reach tens of billions of dollars each year. Additionally, identity theft, physical risk, and an increase in organized criminal groups are raising the potential for fraud activities to harm patients.
93%
of surveyed payer organizations are likely to recommend Cotiviti.*
Designed by credentialed investigators in collaboration with clinical, claims, and regulatory specialists, Cotiviti’s end-to-end FWA Management solutions adapt to emerging fraud schemes and compliance requirements. Our integrated solution set applies data analysis, decisions, and insights from one module into the rules and algorithms of other modules, creating an even stronger anti-fraud solution.
~35%
increase in case management efficiency
15:1
maximum achieved return on investment (ROI)
>$1M
increase in recoveries from just one provider group for one client
increase in case management efficiency
maximum achieved return on investment (ROI)
increase in recoveries from just one provider group for one client
Our modules help solve for a variety of FWA challenges, and include:
*Source: TechValidate. TVID: C55-FBC-364
Our integrated FWA Management solution set is the adaptive solution to your FWA problems. Relying on a combination of data analysis, decisions, and insights, it’s the anti-fraud solution with a list of benefits that include:
FWA Management is part of Cotiviti’s Payment Accuracy solution suite.
