Cotiviti Completes Acquisition of Edifecs.
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Measure and report HEDIS and quality-related metrics your way
Quality Intelligence, Cotiviti's measurement and reporting software with fully NCQA-certified quality measure logic, sets the standard for efficiency, ease of use, and customer satisfaction. Health plans can track, monitor, and improve quality compliance; develop and measure proprietary quality metrics; facilitate HEDIS, Star Ratings, and other quality measure submissions; and implement a year-round measurement and reporting program that significantly improves health plan rankings.
Learn more about Quality Intelligence
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Optimize Medicare Advantage Star Ratings
Star Intelligence gives health plans the ability to track, predict, and model their Star Ratings. This empowers plans with the capability to understand and prioritize actions needed to offer better care to a growing MA population and to optimize bonus payments. Plans can choose to integrate with Quality Intelligence for a more holistic view of members in regards to quality, Star Rating improvement, member engagement, and more.
Learn more about Star Intelligence
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Gain insights into every facet of healthcare utilization
Medical Intelligence combines Cotiviti's industry-leading DxCG science, evidence-based clinical quality rules, healthcare utilization metrics, and claims-based HEDIS measures to enable payers to manage risk and target opportunities for improving healthcare results. Users can easily stratify and segment populations (by risk, costs, utilization, predicted future cost, or location), access member-level detail (e.g., conditions, comorbidities, clinical events, gaps in care, prescription compliance), and evaluate efficiency and performance by program, provider, and more.
Learn more about Medical Intelligence
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Achieve >90% medical record retrieval success with a streamlined solution
Cotiviti's Medical Record Retrieval services provide optimize medical record retrieval, aggregation, indexing, and storage to fulfill even high-volume record requests with minimal disruption to providers and their office staff.
Achieve >97% abstraction accuracy without hiring and training new staff
Cotiviti's Medical Record Abstraction services deliver rapid, accurate abstraction of clinical data components that document the provision of compliant care. Our goal is to achieve the highest number of compliant components possible within any reporting time frame, optimizing health plan quality scores and revenue while helping to close care gaps.
Gain insights into every facet of healthcare utilization
Medical Intelligence combines Cotiviti's industry-leading DxCG science, evidence-based clinical quality rules, healthcare utilization metrics, and claims-based HEDIS measures to enable payers to manage risk and target opportunities for improving healthcare results. Users can easily stratify and segment populations (by risk, costs, utilization, predicted future cost, or location), access member-level detail (e.g., conditions, comorbidities, clinical events, gaps in care, prescription compliance), and evaluate efficiency and performance by program, provider, and more.
Learn more about Medical Intelligence
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Clearly understand and predict individual and population risk
Part of healthcare's DNA for more than 20 years and used by hundreds of organizations, DxCG Intelligence is at the core of Cotiviti's performance analytics solutions. The gold standard in risk adjustment and predictive modeling, DxCG Intelligence analyzes and helps manage the clinical and financial risks associated with caring for populations, with specificity at the individual level. DxCG Intelligence uses Cotiviti's proprietary predictive models, validated in depth by the Society of Actuaries for their breadth and utility, to turn healthcare data into risk scores for individual members.
