Blog

Our latest healthcare insights and perspectives

CONSUMER ENGAGEMENT

Case study: Reaching Medicaid members amid redetermination

Leah Dewey

Nov 30, 2023

Latest Content

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

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