Cotiviti

Cotiviti's got talent! 😎 The Cotiviti Employee Committee recently hosted our fifth annual talent show, drawing incredible submissions across several categories. We invite you to watch this amazing performance by Brian Cui, our senior manager of audit operations, who took home first place in the Performing Arts category! 🎵🎹 Congratulations, Brian!

Longitude Health, formed by Baylor Scott & White Health, Memorial Hermann Health System, Novant Health, and Providence, is set to address the most complex challenges in healthcare. The organization aims to improve health system performance across cost, quality, access, and patient experience by investing in innovative solutions. https://bit.ly/40cSSpS Healthcare Finance News #HealthPlans #healthcare #payments

For smaller SIUs dealing with a high volume of claims, extra support speeds the process of catching fraud, waste, and abuse. In our latest LinkedIn newsletter, Cotiviti's Erin Rutzler explains how Highmark Wholecare prevented inappropriate payments with the help of Claim Pattern Review. 📰

Waste and incorrect billing can cost dental plans billions of dollars per year. Don't miss our speaking session at the 2024 NHCAA Annual Training Conference as we describe how to execute prepay #FWA investigations with meaningful financial impact for dental plans. And don't miss the chance to take home a pair of Loop Experience 2 earplugs by stopping by for a 10-minute demo at booth 415! Play "Expert Eye" while you're there to support the Boys & Girls Clubs of America and take home a new travel kit. Get the details: https://bit.ly/4emlqAD #fraud #HealthPlans #FWA

With increasing emphasis on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey scores in determining Star Ratings, Medicare Advantage plans must adopt a long-term strategy to improve member experiences. Cotiviti Stars analyst Thelma Belli explains why keeping leadership engaged, educating care teams, implementing proactive feedback mechanisms, and effectively increasing member response rates are vital actions. https://bit.ly/3UM43lY RISE #StarRatings #HealthPlans

Skilled nursing facility (SNF) and inpatient rehabilitation facility (IRF) claims carry significant financial risk due to their complexity. These claims require specialized expertise to ensure accurate documentation, coding, and compliance with health plan policies. Without the proper oversight, plans can face lost costs from overpayments. In our blog, Cotiviti's Amy Palilonis Carleton explains how adding expert review to these claims can result in substantial cost recovery and improved accuracy. https://bit.ly/3YWy70C #HealthPlans #payments #healthcare

CMS's recent recalculation of the 2024 Star Ratings is causing Medicare Advantage plans to reassess their strategies. In a recent interview with AJMC's Managed Care Cast, Cotiviti's Marge Ciancetta discusses the challenges and offers strategies to help smaller MA plans optimize their Star Ratings and quality initiatives. https://bit.ly/3z4VSt9 #HealthPlans #HEDIS

As health plans continue to face high medical loss ratios (MLR), optimizing payment integrity goes beyond cost savings by building a resilient, value-driven approach to payment processes. Health plans that integrate technology with human expertise in clinical insights can detect inappropriate billing, avoid unnecessary administrative costs, and enhance the overall member experience. Matthew Hawley, Cotiviti's EVP of payment integrity, writes that while the industry faces mounting financial pressures, advanced payment integrity programs provide a comprehensive solution to long-term sustainability. https://bit.ly/3YCHxwC #HealthPlans #healthcare #payments

In 1940, at the age of 16, Connie Rocha left school to provide for her family and contribute to the war effort. A native Texan from San Antonio, Connie began as a sheet metal mechanic and slowly worked her way up in the ranks, eventually becoming an aircraft mechanic at the Hawaii repair depot. In 1944, Connie transferred back to San Antonio, joining the many women mechanics at Kelly Field known as the "Kelly Katies," and paving the way for a new generation of women in the military. This Veterans Day and Remembrance Day, we give thanks to all who have served in the armed forces and honor you for your dedication and sacrifice. Listen to Connie's story from StoryCorps: https://bit.ly/3Cg6cQq

Cotiviti's experts reflect on the HEDIS Measurement Year (MY) 2023 outcomes and review how to prepare for MY 2024. Learn as we unpack the past year's results and delve into: 🔹 In-depth analysis of the outcomes of MY 2023 🔹 Strategies to effectively prepare for MY 2024 🔹 Actionable insights to set the stage for a successful journey into the next HEDIS cycle. Watch and subscribe on YouTube: https://bit.ly/4g4Byso #HealthPlans #HEDIS