We are proud to announce Eliza® Member Engagement is now part of Cotiviti!
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Second Level Review is part of Cotiviti's
Risk Adjustment solution suite.
With the Risk Adjustment Data Validation (RADV) Final Rule announced in 2023, the Centers for Medicare & Medicaid Services (CMS) has estimated it will recover $4.7 billion from Medicare Advantage plans between 2023 and 2032. Meeting this increased scrutiny along with ever-evolving trends and guidelines, health plans must strengthen their efforts to improve medical record coding accuracy.
of medical records reviewed by our coders
Second Level Review combines technology and expertise for better results. This solution integrates natural language processing (NLP) automation and quality assurance led by our expert teams to review first-pass coding results. We focus on improving the capture of incremental coding opportunities by identifying overlooked diagnoses, as well as on correcting unsupported conditions from the first-pass review. This approach ensures the accurate capture of population risk while reducing compliance risk.
Unlocking business value requires a combination of technological innovation and human expertise. Our Second Level Review combines NLP with human oversight and an in-depth understanding of trends and best practices to help deliver quality results. After leveraging NLP to prepare records for expert analysis, our coding experts validate 100% of findings to deliver the most accurate results, and dedicated reporting provides transparency into outcomes.
Working with Cotiviti Second Level Review can give your plan the support it needs to enhance coding accuracy and ensure compliance. Working with Cotiviti means:
