Our latest healthcare insights and perspectives
FRAUD, WASTE, AND ABUSE
Case study: Highmark Wholecare prevents FWA with Claim Pattern ReviewErin Rutzler
Nov 6, 2024
CONSUMER ENGAGEMENT
Case study: Engaging members to apply for the Low-Income Subsidy (LIS)Leah Dewey
Oct 30, 2024
QUALITY AND STARS
3 takeaways for Medicare Advantage plans from the 2025 Star RatingsMarge Ciancetta
Oct 28, 2024
PAYMENT INTEGRITY
Webinar: What TPAs need to know about payment integrityMichael Jablon
Oct 24, 2024
CONSUMER ENGAGEMENT
Proactive member engagement strategies to close gaps in Medicare AdvantageLeah Dewey
Oct 17, 2024
RISK ADJUSTMENT
Webinar: Key updates to improve coding accuracy in 2025Katie Sender, MSN, RN, PHN, CRC
Oct 11, 2024
RISK ADJUSTMENT
Partnering for success in 3 critical areas of risk adjustmentChad Kinkead
Sep 30, 2024
FRAUD, WASTE, AND ABUSE
Webinar: Lessons learned from a successful prepay FWA programNikki Brody
Sep 23, 2024
PAYMENT INTEGRITY
Recovering improper costs in SNF and IRF claimsAmy Carleton, RN, BSN
Sep 16, 2024
PAYMENT INTEGRITY
4 attributes of a successful specialty drug payment integrity programJonathan Starr, PharmD
Sep 3, 2024
PAYMENT INTEGRITY
eBook: The three pillars of coordination of benefits (COB) successEvan Okulanis
Aug 26, 2024
QUALITY AND STARS
Podcast: Star Ratings strategies for smaller MA plansMarge Ciancetta
Aug 22, 2024
QUALITY AND STARS
Webinar: Decoding the HEDIS MY 2025 Technical SpecificationsSamantha Davis
Aug 20, 2024
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching outlier behaviors in physical therapy claimsMelanie Poole
Aug 8, 2024
RISK ADJUSTMENT
Webinar: Integrating internal and external risk adjustment innovationsTracey Bradberry
Aug 6, 2024
PAYMENT INTEGRITY
Checklist: How to build a valuable coordination of benefits programEvan Okulanis
Aug 1, 2024
RISK ADJUSTMENT
Navigating new frontiers in interoperabilityKatie Devlin, DHSc, MS, CPHIMS
Jul 30, 2024
RISK ADJUSTMENT
10 tips for a successful commercial risk adjustment programKatie Sender, MSN, RN, PHN, CRC
Jul 23, 2024
PAYMENT INTEGRITY
FRAUD, WASTE, AND ABUSE
Video: Navigating new frontiers in FWA and payment integrityErin Rutzler
Jul 16, 2024
RISK ADJUSTMENT
Video: Navigating new frontiers in risk adjustmentKatie Sender, MSN, RN, PHN, CRC
Jul 9, 2024
QUALITY AND STARS
Quality Decoded webinar: Preparing for HEDIS MY 2024Jamison Gillitzer
Jul 3, 2024
PAYMENT INTEGRITY
3 strategies for payers to curb increasing medical loss ratiosMichael Jablon
Jun 17, 2024
PAYMENT INTEGRITY
White paper: Getting self-insured employer groups on board with payment integrityMatthew Hawley
Jun 13, 2024
FRAUD, WASTE, AND ABUSE
FWA Insights: Analysis confirms >$1 million in improper claimsErin Rutzler
Jun 10, 2024
PAYMENT INTEGRITY
Case study: Protecting financial integrity with prepay review solutionsWarren Lesnefsky
Jun 5, 2024
PAYMENT INTEGRITY
Podcast: How to build a valuable coordination of benefits programBeth Waibel
Jun 3, 2024
ENTERPRISE DATA ANALYTICS
Navigating new frontiers in healthcare: 3 takeaways from CCC24Brett Arnold
May 29, 2024
CONSUMER ENGAGEMENT
5 steps for proactive member engagement following Medicaid redeterminationsLeah Dewey
May 23, 2024
QUALITY AND STARS
Podcast: New Star Ratings strategies for success in 2025 and beyondMarge Ciancetta
May 20, 2024
PAYMENT INTEGRITY
eBook: How to achieve “total value” in payment integrityMatthew Hawley
May 8, 2024
QUALITY AND STARS
RISK ADJUSTMENT
White Paper: Executing high-performing interoperability programs to enable clinical dataKatie Devlin, DHSc, MS, CPHIMS
May 2, 2024
RISK ADJUSTMENT
3 key risk adjustment strategies to drive success in 2024Katie Sender, MSN, RN, PHN, CRC
Apr 18, 2024
PAYMENT INTEGRITY
Webinar: Unlock the “Total Value” of your payment integrity programMichael Jablon
Apr 16, 2024
QUALITY AND STARS
Webinar: Implications of the 2025 CMS Final Rate Announcement for quality programsMarge Ciancetta
Apr 11, 2024
PAYMENT INTEGRITY
Case study: Coordination of benefits (COB) results soar for large national planEvan Okulanis
Apr 9, 2024
PAYMENT INTEGRITY
Podcast: The "Total Value" approach to payment integrityJeff Robinson
Mar 26, 2024
RISK ADJUSTMENT
New approaches to enhance risk adjustment at RISE National 2024Katie Sender, MSN, RN, PHN, CRC
Mar 5, 2024
RISK ADJUSTMENT
RISE Webinar: Key risk adjustment trends to watch in 2024Branka Sustic
Feb 26, 2024
QUALITY AND STARS
Quality Decoded webinar series: 2025 CMS Advance NoticeMarge Ciancetta
Feb 20, 2024
QUALITY AND STARS
RISK ADJUSTMENT
3 interoperability updates for payers in 2024Katie Devlin, DHSc, MS, CPHIMS
Feb 14, 2024
QUALITY AND STARS
RISK ADJUSTMENT
3 takeaways from the 2025 Advance NoticeBranka Sustic
Feb 8, 2024
FRAUD, WASTE, AND ABUSE
FWA Insights: Examining a suspicious volume of HCPCS codesMelanie Poole
Jan 31, 2024
PAYMENT INTEGRITY
White Paper: Improving payment integrity with inpatient claim reviewCheri Moehring
Jan 29, 2024
FRAUD, WASTE, AND ABUSE
Case study: Integrated prepay and FWA solutions deliver improved claim accuracyVince Smith, AHFI, CFE
Jan 24, 2024
FRAUD, WASTE, AND ABUSE
Preparing for 2024 trends in healthcare FWA: CPT code updates and beyondMary Cate Anderson, HCAFA
Jan 17, 2024
ENTERPRISE DATA ANALYTICS
Best of 2023: Explore Cotiviti’s top content from last yearJeff Robinson
Jan 9, 2024
FRAUD, WASTE, AND ABUSE
Webinar: Preparing for investigative strategies in 2024Mary Cate Anderson, HCAFA
Dec 5, 2023
CONSUMER ENGAGEMENT
Case study: Reaching Medicaid members amid redeterminationLeah Dewey
Nov 30, 2023
QUALITY AND STARS
Closing the Gap: Improving chronic disease screening and careJamison Gillitzer
Nov 28, 2023
PAYMENT INTEGRITY
Case study: Data mining for errors yields more accurate pharmacy paymentsMatthew Herbein
Nov 16, 2023
FRAUD, WASTE, AND ABUSE
Busted: The top healthcare fraud schemes of Q3 2023Erin Rutzler
Nov 14, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging suspicious activity related to COVID-19 testingErin Rutzler
Nov 8, 2023
CONSUMER ENGAGEMENT
Video: Reducing disparities in care during Global Health Equity WeekKassi Yozzo
Oct 26, 2023
QUALITY AND STARS
Closing the Gap: Better preventative measures for breast cancerAshley McNairy
Sep 28, 2023
QUALITY AND STARS
White paper: Implementing a digital quality strategyKatie Devlin, DHSc, MS, CPHIMS
Sep 20, 2023
QUALITY AND STARS
NCQA confirms HEDIS® updates for Measurement Year (MY) 2024Samantha Davis
Sep 18, 2023
PAYMENT INTEGRITY
Savings spotlight: Dental claim review expertise nets significant savingsSteve Canfield, DDS
Sep 13, 2023
FRAUD, WASTE, AND ABUSE
Webinar: Finding new schemes with AI and investigative techniquesErin Rutzler
Sep 11, 2023
QUALITY AND STARS
Podcast: Enhancing interoperability for better risk and quality outcomesKassi Yozzo
Sep 6, 2023
QUALITY AND STARS
Closing the Gap: Maintaining healthy cholesterol and improving medication adherenceMatt Simon
Aug 31, 2023
PAYMENT INTEGRITY
Podcast: Payment integrity for self-insured (ASO) employer groupsJeff Robinson
Aug 16, 2023
PAYMENT INTEGRITY
Video: A new approach to prepay coordination of benefits (COB) validationNaomi Murphy
Aug 14, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching schemes related to Ozempic, Wegovy, and semaglutidesMelanie Poole
Aug 2, 2023
QUALITY AND STARS
Closing the Gap: National Immunization Awareness MonthJamison Gillitzer
Jul 31, 2023
QUALITY AND STARS
Navigating changes in Star Ratings programs: Enhancing success with four key stepsMarge Ciancetta
Jul 24, 2023
PAYMENT INTEGRITY
Webinar: Making payment integrity work for your self-insured groupsAllyn Sullivan
Jul 19, 2023
PAYMENT INTEGRITY
4 strategies to curb medical cost increases as healthcare utilization reboundsMatthew Hawley
Jul 10, 2023
QUALITY AND STARS
Closing the Gap: Minority Mental Health AwarenessKatie Devlin, DHSc, MS, CPHIMS
Jun 29, 2023
CONSUMER ENGAGEMENT
Podcast: Preventing coverage loss during redeterminationJeff Robinson
Jun 14, 2023
QUALITY AND STARS
Preparing for a “Universal Foundation” of quality measuresBranka Sustic
Jun 12, 2023
FRAUD, WASTE, AND ABUSE
How to sequence FWA investigations for greater impactErin Rutzler
Jun 7, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging high-frequency telehealth claimsErin Rutzler
Jun 1, 2023
QUALITY AND STARS
Webinar: Optimizing MA Star Ratings with Star IntelligenceAshley McNairy
May 23, 2023