How is Cotiviti enabling health plans to navigate new frontiers in member engagement? Watch our recent video from the 2024 Cotiviti Client Conference (CCC24) featuring Leah Dewey, vice president of clinical and consumer engagement operations. Stay tuned as our video series concludes next week with a look at how Cotiviti is advancing interoperability!
About us
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, consumer engagement, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.
- Website
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http://www.cotiviti.com
External link for Cotiviti
- Industry
- IT Services and IT Consulting
- Company size
- 5,001-10,000 employees
- Headquarters
- South Jordan, UT
- Type
- Public Company
- Specialties
- Analytics, Payment Integrity, Payer Liability, Payment Accuracy, Clinical Appropriateness, Coding Compliance, Contract Compliance, Procure-to-Pay, Supplier Audit, Overpayment Recovery, Healthcare, Retail, Pay-for-Value, HEDIS, Risk Adjustment, and Provider Network Performance
Locations
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Primary
10701 S River Front Pkwy, Unit 200
Unit 200
South Jordan, UT 84095, US
Employees at Cotiviti
Updates
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How is Cotiviti empowering health plans to navigate new frontiers in interoperability for better outcomes in risk adjustment, quality, and more? Watch our recent video from the 2024 Cotiviti Client Conference (CCC24) featuring Katie Devlin, DHSc, MS, CPHIMS, vice president of interoperability. Catch up on our Navigating New Frontiers video series right here on our healthcare payer resource center! ➡️ https://lnkd.in/edrRp5dV
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Addressing rising healthcare costs while improving member satisfaction necessitates a robust coordination of benefits (COB) program. Read our new COB checklist as we discuss: 🔹 Implementing data enrichment 🔹 Targeting claims with potential discoveries 🔹 Incorporating human knowledge Find out how to establish a beneficial COB program and prepare for future challenges. https://bit.ly/3RT4Ek3 #HealthPlans #COB
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Centering provider and member experience will be vital in accelerating value-based care in the coming years. The payer industry has seen many calls to accelerate this approach, but achieving this goal requires a concerted effort to improve the experiences of both providers and members. https://bit.ly/3VZ1uMW HealthPayerIntelligence #HealthPlans #healthcare
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Webinar: Join Cotiviti's Quality and Stars team, which will review the latest measure specifications and guide your team in addressing the annual publication of confirmed measure updates for the HEDIS Measurement Year (MY) 2025. You'll gain valuable insights into the confirmed updates, areas of focus, and practical strategies for your team. Mark your calendar for September 4 at 1:00 PM ET and register here: https://bit.ly/3A4siE9 #HEDIS #HealthPlans #payments
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Specialty drugs are a complex area of claims processing, with almost half of specialty drug claims occuring under a health plan's medical benefit rather than the pharmacy benefit. This complexity and expense make specialty drug claims prone to inaccurate billing, or worse, fraud, waste, and abuse. Watch our latest YouTube webinar for critical insights, including why relying solely on prior authorization can result in limited details that can leave plans open to inappropriate claims. Subscribe to our YouTube channel for more. https://bit.ly/3tR0vUF #HealthPlans #FWA #fraud
Beyond prior authorization: Ensuring accuracy of specialty drug claims
https://www.youtube.com/
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As a health plan facing RADV and OIG audits, it's time to strengthen your risk adjustment strategies. Join Cotiviti's experts on Thursday, August 15, at 1:00 pm ET for a webinar on integrating internal and external innovations to strengthen risk adjustment results and compliance. Learn how to address resource constraints, integrate new technologies, and leverage industry insights to improve data accuracy and efficiency. Don't miss this opportunity to learn valuable knowledge from our experts, Tracey Bradberry, Katie Devlin, DHSc, MS, CPHIMS, and Katie Koester Sender! Register for the webinar. https://bit.ly/4c7v3Sz #RiskAdjustment #HealthPlans #RiskAdjustment #HealthPlans
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The Trusted Exchange Framework and Common Agreement (TEFCA) aims to create a unified framework for health data exchange. The Sequoia Project released the second draft of the Common Agreement in 2024, significantly expanding operational use cases relevant to payers, including quality improvement, risk adjustment, and payment integrity. As Cotiviti's Katie Devlin, DHSc, MS, CPHIMS, explains, health plan leaders must consider if joining a Qualified Health Information Network (QHIN) will help facilitate interoperability. https://bit.ly/3ykQ0vy DOTmed.com, Inc #HealthPlans #payments #healthcare
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The U.S. Supreme Court has overturned the 40-year-old Chevron deference standard, meaning courts will no longer have to rely on agency expertise to review challenged regulations. The 6-3 decision marks a significant shift in administrative law and could profoundly affect healthcare stakeholders over time. https://bit.ly/3zvHVUZ HealthLeaders #healthcare #HealthPlans
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While upcoding is the most common "creative billing" scheme for behavioral health, many other schemes are gaining ground. These include: 🔹 Cloning records and boilerplate billing. 🔹 Inappropriate billing of applied behavioral analysis (ABA) therapy. 🔹 Billing impossible days. Discover what's new from Cotiviti's Erin Rutzler, our Vice President of Fraud, Waste and Abuse. https://bit.ly/3XHITrl #FWA #MentalHealth #telehealth
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