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Our latest healthcare insights and perspectives

PAYMENT INTEGRITY

Podcast: The "Total Value" approach to payment integrity

Jeff Robinson

Mar 26, 2024

Latest Content

RISK ADJUSTMENT

New approaches to enhance risk adjustment at RISE National 2024

Katie Sender, MSN, RN, PHN, CRC

Mar 5, 2024

QUALITY AND STARS

NCQA releases proposed HEDIS MY 2025 updates

Samantha Davis

Feb 28, 2024

RISK ADJUSTMENT

RISE Webinar: Key risk adjustment trends to watch in 2024

Branka Sustic

Feb 26, 2024

QUALITY AND STARS

Quality Decoded webinar series: 2025 CMS Advance Notice

Marge Ciancetta

Feb 20, 2024

QUALITY AND STARS

RISK ADJUSTMENT

3 interoperability updates for payers in 2024

Katie Devlin, DHSc, MS, CPHIMS

Feb 14, 2024

QUALITY AND STARS

RISK ADJUSTMENT

3 takeaways from the 2025 Advance Notice

Branka Sustic

Feb 8, 2024

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q4 2023

Erin Rutzler

Feb 6, 2024

FRAUD, WASTE, AND ABUSE

FWA Insights: Examining a suspicious volume of HCPCS codes

Melanie Poole

Jan 31, 2024

PAYMENT INTEGRITY

White paper: Improving payment integrity with inpatient claim review

Cheri Moehring

Jan 29, 2024

FRAUD, WASTE, AND ABUSE

Case study: Integrated prepay and FWA solutions deliver improved claim accuracy

Vince Smith, AHFI, CFE

Jan 24, 2024

FRAUD, WASTE, AND ABUSE

Preparing for 2024 trends in healthcare FWA: CPT code updates and beyond

Mary Cate Anderson, HCAFA

Jan 17, 2024

QUALITY AND STARS

eBook: Closing care gaps in 12 critical areas in 2024

Chad Kinkead

Jan 11, 2024

ENTERPRISE DATA ANALYTICS

Best of 2023: Explore Cotiviti’s top content from last year

Jeff Robinson

Jan 9, 2024

PAYMENT INTEGRITY

Case study: The impact of prospective DRG validation

Cheri Moehring

Dec 12, 2023

FRAUD, WASTE, AND ABUSE

Webinar: Preparing for investigative strategies in 2024

Mary Cate Anderson, HCAFA

Dec 5, 2023

CONSUMER ENGAGEMENT

Case study: Reaching Medicaid members amid redetermination

Leah Dewey

Nov 30, 2023

QUALITY AND STARS

Closing the Gap: Improving chronic disease screening and care

Jamison Gillitzer

Nov 28, 2023

PAYMENT INTEGRITY

Case study: Data mining for errors yields more accurate pharmacy payments

Matthew Herbein

Nov 16, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q3 2023

Erin Rutzler

Nov 14, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Flagging suspicious activity related to COVID-19 testing

Erin Rutzler

Nov 8, 2023

CONSUMER ENGAGEMENT

Webinar: A progress report on Medicaid redetermination

Leah Dewey

Nov 6, 2023

QUALITY AND STARS

Closing the Gap: American Diabetes Month

Marge Ciancetta

Nov 2, 2023

CONSUMER ENGAGEMENT

Video: Reducing disparities in care during Global Health Equity Week

Kassi Yozzo

Oct 26, 2023

QUALITY AND STARS

3 takeaways from the 2024 Star Ratings

Marge Ciancetta

Oct 23, 2023

QUALITY AND STARS

RISE Webinar: Star Ratings Reflections

Ashley McNairy

Oct 12, 2023

PAYMENT INTEGRITY

Podcast: Optimizing inpatient claim review

Jeff Robinson

Oct 10, 2023

QUALITY AND STARS

Closing the Gap: Better preventative measures for breast cancer

Ashley McNairy

Sep 28, 2023

QUALITY AND STARS

White paper: Implementing a digital quality strategy

Katie Devlin, DHSc, MS, CPHIMS

Sep 20, 2023

QUALITY AND STARS

NCQA confirms HEDIS® updates for Measurement Year (MY) 2024

Samantha Davis

Sep 18, 2023

PAYMENT INTEGRITY

Savings spotlight: Dental claim review expertise nets significant savings

Steve Canfield, DDS

Sep 13, 2023

FRAUD, WASTE, AND ABUSE

Webinar: Finding new schemes with AI and investigative techniques

Erin Rutzler

Sep 11, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q2 2023

Erin Rutzler

Aug 29, 2023

PAYMENT INTEGRITY

Podcast: Payment integrity for self-insured (ASO) employer groups

Jeff Robinson

Aug 16, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Catching schemes related to Ozempic, Wegovy, and semaglutides

Melanie Poole

Aug 2, 2023

QUALITY AND STARS

Closing the Gap: National Immunization Awareness Month

Jamison Gillitzer

Jul 31, 2023

QUALITY AND STARS

eBook: Improving care gap closure in 2023 and beyond

Chad Kinkead

Jul 26, 2023

PAYMENT INTEGRITY

Webinar: Making payment integrity work for your self-insured groups

Allyn Sullivan

Jul 19, 2023

QUALITY AND STARS

Webinar: Making the most of HEDIS downtime

Branka Sustic

Jul 12, 2023

QUALITY AND STARS

Closing the Gap: Minority Mental Health Awareness

Katie Devlin, DHSc, MS, CPHIMS

Jun 29, 2023

PAYMENT INTEGRITY

Webinar: A Claim Pattern Review case study

Ed McCormick

Jun 19, 2023

CONSUMER ENGAGEMENT

Podcast: Preventing coverage loss during redetermination

Jeff Robinson

Jun 14, 2023

QUALITY AND STARS

Preparing for a “Universal Foundation” of quality measures

Branka Sustic

Jun 12, 2023

FRAUD, WASTE, AND ABUSE

How to sequence FWA investigations for greater impact

Erin Rutzler

Jun 7, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Flagging high-frequency telehealth claims

Erin Rutzler

Jun 1, 2023

QUALITY AND STARS

Closing the Gap: Men’s Health Month

Marge Ciancetta

May 30, 2023

PAYMENT INTEGRITY

3 takeaways from CCC23 to improve payment integrity

Matthew Hawley

May 24, 2023

QUALITY AND STARS

Webinar: Optimizing MA Star Ratings with Star Intelligence

Ashley McNairy

May 23, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q1 2023

Erin Rutzler

May 4, 2023

CONSUMER ENGAGEMENT

Closing the Gap: Improving osteoporosis prevention

Gabe Boucher

Apr 27, 2023

PAYMENT INTEGRITY

White paper: The “smart prepay” approach to payment integrity

Matthew Hawley

Apr 20, 2023

QUALITY AND STARS

CONSUMER ENGAGEMENT

Closing the Gap: National Minority Health Month

Leah Dewey

Apr 17, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Prepay review leads to >$100K in projected annual savings

Erin Rutzler

Mar 28, 2023

FRAUD, WASTE, AND ABUSE

Webinar: Sequencing investigative activities for greater provider impact

Erin Rutzler

Mar 22, 2023

FRAUD, WASTE, AND ABUSE

Podcast: How health plans investigate and prevent FWA

Jeff Robinson

Mar 2, 2023

QUALITY AND STARS

Summary: NCQA releases proposed HEDIS changes for MY 2024 and MY 2025

Samantha Davis

Feb 23, 2023

QUALITY AND STARS

Closing the Gap: Preventative measures for better heart health

Ashley McNairy

Feb 21, 2023

QUALITY AND STARS

Rounding up Star Ratings changes in the 2024 Advance Notice

Ashley McNairy

Feb 16, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q4 2022

Erin Rutzler

Feb 14, 2023

ENTERPRISE DATA ANALYTICS

Watch the top 5 webinars of 2022

Warren Lesnefsky

Feb 9, 2023

CONSUMER ENGAGEMENT

Taking action to prepare for Medicaid redetermination

Leah Dewey

Feb 7, 2023

RISK ADJUSTMENT

Forging ahead after the Medicare Advantage RADV Final Rule

Cotiviti

Feb 6, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Navigating 2023 CPT code changes

Erin Rutzler

Jan 30, 2023

QUALITY AND STARS

Closing the Gap: Improving cervical cancer prevention

Jamison Gillitzer

Jan 25, 2023

PAYMENT INTEGRITY

eBook: The payment integrity playbook for success in 2023 and beyond

Jordan Bazinsky

Jan 17, 2023

FRAUD, WASTE, AND ABUSE

Maintaining a strong and successful SIU in 2023

Erin Rutzler

Dec 14, 2022

PAYMENT INTEGRITY

How Data Mining helps clean up your claim payment stream

Susan Murray

Dec 8, 2022

FRAUD, WASTE, AND ABUSE

Webinar: Deter FWA in 2023 with the latest investigative strategies

Erin Rutzler

Nov 29, 2022

FRAUD, WASTE, AND ABUSE

Focusing on prepay FWA prevention at NHCAA's Annual Training Conference

Erin Rutzler

Nov 14, 2022

CONSUMER ENGAGEMENT

How payers can drive collaboration to support health equity

Leah Dewey

Nov 8, 2022

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q3 2022

Erin Rutzler

Oct 27, 2022

PAYMENT INTEGRITY

3 key tips for managing your payment integrity portfolio

Jordan Bazinsky

Oct 24, 2022

QUALITY AND STARS

Bouncing back from the 2023 Star Ratings

Ashley McNairy

Oct 19, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Managing FWA for dental claims

Cindy Egan

Oct 17, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Spotting overpayments in mental health services

Melanie Poole

Sep 28, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Catching inappropriate billing within ASD services

Erin Rutzler

Sep 14, 2022

FRAUD, WASTE, AND ABUSE

SIU panel discussion: Best practices in healthcare payer FWA

Erin Rutzler

Sep 12, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Flagging for excessive modifiers

Melanie Poole

Sep 1, 2022

PAYMENT INTEGRITY

Webinar series: Accuracy along the payment continuum

Jordan Bazinsky

Aug 23, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Spotting red flags in adult day care claims

Erin Rutzler

Aug 18, 2022

QUALITY AND STARS

Podcast: Cotiviti SVP Rachael Jones on health equity strategy

Jeff Robinson

Aug 11, 2022

NETWORK AND CLINICAL ANALYTICS

On-demand webinar: Pursuing better value-based care with Florida Blue Medicare

Mary Srinivas

Aug 9, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Flagging potential physical therapy schemes

Melanie Poole

Aug 4, 2022

PAYMENT INTEGRITY

Video: How to shorten time to payment integrity results

Matthew Hawley

Aug 3, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: How to catch a DME scheme

Erin Rutzler

Jul 26, 2022

QUALITY AND STARS

HEDIS® strategies: 4 ways to prepare for the ECDS transition

Ashley McNairy

Jul 18, 2022

QUALITY AND STARS

Webinar: Reviewing HEDIS MY 2021 and looking ahead to MY 2022

Jamison Gillitzer

Jun 30, 2022

FRAUD, WASTE, AND ABUSE

Webinar: Catching potential drug testing fraud

Carlyn Hoffman

Jun 21, 2022

PAYMENT INTEGRITY

3 key elements of a successful employment verification process

Naomi Murphy

Jun 15, 2022

PAYMENT INTEGRITY

FRAUD, WASTE, AND ABUSE

White paper: Detecting and preventing FWA in behavioral health claims

Erin Rutzler

Jun 1, 2022

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q1 2022

Erin Rutzler

May 24, 2022

NETWORK AND CLINICAL ANALYTICS

Podcast: The importance of interoperability in value-based care

Jeff Robinson

May 13, 2022

PAYMENT INTEGRITY

Section 340B overview: Medicare, Medicaid, covered entities, and more

Kristie Ressler, D.O.

May 3, 2022

NETWORK AND CLINICAL ANALYTICS

Podcast: Improving risk assessment for better care outcomes

Jeff Robinson

Apr 12, 2022

PAYMENT INTEGRITY

Specialty drugs: Why go beyond prior authorization?

Jonathan Starr, PharmD

Mar 23, 2022

QUALITY AND STARS

NETWORK AND CLINICAL ANALYTICS

CONSUMER ENGAGEMENT

3 areas of investment for payers to improve health equity in 2022

Cotiviti

Mar 17, 2022

NETWORK AND CLINICAL ANALYTICS

Webinar: The path to adopting a successful Alternative Payment Model

Mary Srinivas

Mar 15, 2022

QUALITY AND STARS

NCQA publishes proposed changes to HEDIS measures for MY 2023

Samantha Davis

Feb 24, 2022

QUALITY AND STARS

CMS 2023 Advance Notice: Health equity takes center stage

RaeAnn Grossman and Jennifer Ach

Feb 10, 2022

CONSUMER ENGAGEMENT

On-demand webinar: Meet your members where they are and move them to act

Roberto Arce

Jan 26, 2022

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q4 2021

Erin Rutzler

Jan 20, 2022

PAYMENT INTEGRITY

On-demand webinar: Understand the 2022 CPT code changes

Amy Hodges

Dec 7, 2021

FRAUD, WASTE, AND ABUSE

What’s old is new again: 3 healthcare fraud trends to watch for in 2022

Erin Rutzler

Dec 2, 2021

CONSUMER ENGAGEMENT

Preparing for Medicaid renewals in 2022

Roberto Arce

Nov 16, 2021

FRAUD, WASTE, AND ABUSE

Preparing your payment integrity programs for 2022 and beyond

Erin Rutzler

Nov 8, 2021

CONSUMER ENGAGEMENT

Podcast: Welcoming, onboarding, and retaining members in the new year

Jeff Robinson

Nov 1, 2021

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q3 2021

Erin Rutzler

Oct 26, 2021

QUALITY AND STARS

Learning from 2022 Star Ratings and planning for 2023–2024

Ashley McNairy

Oct 19, 2021

COTIVITI LEADERSHIP

Podcast: Embracing change in healthcare and beyond

Jeff Robinson

Oct 14, 2021

CONSUMER ENGAGEMENT

Staving off the “twindemic” by boosting flu immunization rates

Jennifer Forster

Oct 6, 2021

PAYMENT INTEGRITY

E&M over-coding: How can payers solve this costly challenge?

Richard Pozen, M.D.

Sep 29, 2021

CONSUMER ENGAGEMENT

Boosting childhood vaccination rates amid a resurging pandemic

Jennifer Forster

Aug 19, 2021

ENTERPRISE DATA ANALYTICS

Video: Ensuring that healthcare data is shared ethically

Jeff Robinson

Jul 26, 2021

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q2 2021

Erin Rutzler

Jul 20, 2021

CONSUMER ENGAGEMENT

5 tips for improving and sustaining member satisfaction

Anne L. Davis

Jul 15, 2021

QUALITY AND STARS

On-demand webinar: Staying active during a shorter HEDIS off-season

Branka Sustic

Jul 13, 2021

NETWORK AND CLINICAL ANALYTICS

3 strategies to boost payer-provider collaboration amid COVID-19

Jeff Robinson

Jun 17, 2021

NETWORK AND CLINICAL ANALYTICS

Redefining value: practical tactics to spur value-based care adoption

Leah Dewey

Jun 10, 2021

QUALITY AND STARS

Video: Improving efficiency across quality improvement teams

David Wolf

May 13, 2021

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q1 2021

Erin Rutzler

Apr 15, 2021

NETWORK AND CLINICAL ANALYTICS

Q&A: Improving value-based care through data and collaboration

Mary Srinivas

Apr 6, 2021

ENTERPRISE DATA ANALYTICS

Podcast: The role of AI during COVID-19 and in a post-pandemic world

Jeff Robinson

Mar 31, 2021

PAYMENT INTEGRITY

Keeping members in mind: Optimizing coordination of benefits

Naomi Murphy

Mar 23, 2021

QUALITY AND STARS

NCQA publishes proposed changes to HEDIS measures for MY 2022

Jamison Gillitzer

Mar 2, 2021

QUALITY AND STARS

CMS Star Ratings: Navigating changes in 2021 and the coming years

Ashley McNairy

Feb 16, 2021

PAYMENT INTEGRITY

Busted: The top healthcare fraud schemes of Q4 2020

Erin Rutzler

Jan 25, 2021

COTIVITI LEADERSHIP

3 predictions for healthcare in 2021 from Cotiviti CEO Emad Rizk, M.D.

Jeff Robinson

Dec 21, 2020

Webinar: Breaking down the 2021 CPT® code changes

Cherie Mazeffa, D.O.

Dec 9, 2020

MEDICARE ADVANTAGE

CMS 2022 Advance Notice: 4 key takeaways for MA plans

David Costello

Dec 3, 2020

QUALITY AND STARS

Precision medicine’s value to complex disease management

Shyamali Mukerjee

Nov 3, 2020

QUALITY AND STARS

Cotiviti clients outperform the field in 2021 Star Ratings

Ashley McNairy

Oct 14, 2020

NETWORK AND CLINICAL ANALYTICS

Case study: Accelerating value-driven care through provider specialty tiering

Mac Davis

Oct 2, 2020

COTIVITI LEADERSHIP

COVID-19

Video: Cotiviti CEO Emad Rizk, M.D., on the current state of interoperability

Tom Betar

Sep 16, 2020

ENTERPRISE DATA ANALYTICS

Podcast: Cotiviti SVP Rachael Jones on the power of predictive data

Tom Betar

Sep 10, 2020

COTIVITI LEADERSHIP

Podcast: Cotiviti's Jordan Bazinsky on the state of payer data

Jeff Robinson

Aug 20, 2020

COVID-19

PAYMENT INTEGRITY

Q&A: Highmark's payment integrity director on new COVID-19 claim trends

Michael Jablon

Aug 17, 2020

QUALITY AND STARS

Q&A: How Arkansas Blue Cross created a value-based payment model

Rachael Jones

Aug 5, 2020

MEDICAID

COVID-19

PAYMENT INTEGRITY

Five critical areas of focus for Medicaid plans amid COVID-19

Bonnie Phillips

Jul 15, 2020

COVID-19

PAYMENT INTEGRITY

Busted: the top COVID-19 healthcare fraud schemes

Erin Rutzler

Jul 13, 2020

QUALITY AND STARS

COVID-19

Webinar: Turning the page on this year's HEDIS season

Branka Sustic

Jul 2, 2020

COVID-19

PAYMENT INTEGRITY

Video: Preventing healthcare fraud, waste, and abuse before paying claims

Erin Rutzler

Jun 24, 2020

ENTERPRISE DATA ANALYTICS

COVID-19

How COVID-19 has highlighted the urgency of interoperability

Tom Betar

Jun 18, 2020

PAYMENT INTEGRITY

Webinar: Achieving payment integrity success amid COVID-19

Michelle DeNetto, M.D.

Jun 11, 2020

ENTERPRISE DATA ANALYTICS

Preparing for the aftermath: collecting COVID-19 analytic insights

Rachael Jones

Jun 9, 2020

QUALITY AND STARS

Webinar: A data-driven approach to value-based payment

Mac Davis

May 28, 2020

COTIVITI LEADERSHIP

COVID-19

Video: CEO Emad Rizk, M.D. on Cotiviti's COVID-19 Outbreak Tracker

Tom Betar

May 27, 2020

QUALITY AND STARS

How employers can use claims data to address opioid addiction

Tom Betar

May 18, 2020

COTIVITI LEADERSHIP

COVID-19

Navigating data sharing and patient privacy amid public health crises

Tom Betar

Apr 24, 2020

COVID-19

COVID-19 claim editing: coding resources for health plans

Michelle DeNetto, M.D.

Apr 1, 2020

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