Cotiviti Blog (2)

Featured

FRAUD, WASTE, AND ABUSE

Webinar: Reducing FWA through partnership

Angela Mitchell

Sep 4, 2026

Latest Content

QUALITY & STARS

Webinar: Decoding the latest HEDIS tech specs

Samantha Davis

Sep 1, 2026

FRAUD, WASTE, AND ABUSE DENTAL CLAIM ACCURACY PAYMENT ACCURACY

White Paper: Uncovering dental claim errors through advanced analytics

Steven M. Canfield, D.D.S.

Aug 26, 2026

VALUE-BASED PAYMENTS & INSIGHTS

Webinar series: Real AI solutions for value-based care

Demi Plessas, Ph.D.

Aug 24, 2026

FRAUD, WASTE, AND ABUSE

6 key capabilities to advance beyond traditional FWA lead detection

Vince Smith, AHFI, CFE

Jan 27, 2025

QUALITY AND STARS

The 2026 CMS Advance Notice: 3 key takeaways

Branka Sustic

Jan 21, 2025

ENTERPRISE DATA ANALYTICS

Best of 2024: Explore Cotiviti’s top content from last year

Jeff Robinson

Jan 14, 2025

FRAUD, WASTE, AND ABUSE

White Paper: Enhancing dental payment accuracy to combat FWA

Steven M. Canfield, D.D.S.

Dec 18, 2024

FRAUD, WASTE, AND ABUSE

Webinar: Advancing beyond traditional FWA lead detection

Ryan Cleverly, AHFI

Dec 3, 2024

PAYMENT INTEGRITY

Case study: Benefits administrator achieves millions in payment integrity value

Michael Jablon

Nov 25, 2024

RISK ADJUSTMENT

Podcast: Driving lasting impact through interoperability

Kassi Yozzo

Nov 20, 2024

FRAUD, WASTE, AND ABUSE

Realizing the evolution of FWA prevention and management

Warren Lesnefsky

Nov 18, 2024

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q3 2024

Erin Rutzler, AHFI, CFE, CHC, CPC

Nov 13, 2024

FRAUD, WASTE, AND ABUSE

Case study: Highmark Wholecare prevents FWA with Claim Pattern Review

Erin Rutzler, AHFI, CFE, CHC, CPC

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 Ratings

Marge Ciancetta

Oct 28, 2024

PAYMENT INTEGRITY

Webinar: What TPAs need to know about payment integrity

Michael Jablon

Oct 24, 2024

CONSUMER ENGAGEMENT

Proactive member engagement strategies to close gaps in Medicare Advantage

Leah Dewey

Oct 17, 2024

RISK ADJUSTMENT

Webinar: Key updates to improve coding accuracy in 2025

Katie Sender, MSN, RN, PHN, CRC

Oct 11, 2024

QUALITY AND STARS

Webinar: Decoding the 2025 Star Ratings

Marge Ciancetta

Oct 8, 2024

RISK ADJUSTMENT

Partnering for success in 3 critical areas of risk adjustment

Chad Kinkead

Sep 30, 2024

QUALITY AND STARS

Decoding the HEDIS MY 2025 Technical Specifications

Samantha Davis

Sep 25, 2024

FRAUD, WASTE, AND ABUSE

Webinar: Lessons learned from a successful prepay FWA program

Nikki Brody

Sep 23, 2024

PAYMENT INTEGRITY

Recovering improper costs in SNF and IRF claims

Amy Carleton, RN, BSN

Sep 16, 2024

PAYMENT INTEGRITY

eBook: How AI can drive health plan success

Brett Arnold

Sep 11, 2024

PAYMENT INTEGRITY

4 attributes of a successful specialty drug payment integrity program

Jonathan Starr, PharmD

Sep 3, 2024

CONSUMER ENGAGEMENT

Webinar: Engaging with members at the end of the year

Leah Dewey

Aug 28, 2024

PAYMENT INTEGRITY

eBook: The three pillars of coordination of benefits (COB) success

Evan Okulanis

Aug 26, 2024

QUALITY AND STARS

Podcast: Star Ratings strategies for smaller MA plans

Marge Ciancetta

Aug 22, 2024

QUALITY AND STARS

Webinar: Decoding the HEDIS MY 2025 Technical Specifications

Samantha Davis

Aug 20, 2024

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q2 2024

Erin Rutzler, AHFI, CFE, CHC, CPC

Aug 15, 2024

FRAUD, WASTE, AND ABUSE

FWA Insights: Catching outlier behaviors in physical therapy claims

Melanie Poole

Aug 8, 2024

RISK ADJUSTMENT

Webinar: Integrating internal and external risk adjustment innovations

Tracey Bradberry

Aug 6, 2024

PAYMENT INTEGRITY

Checklist: How to build a valuable coordination of benefits program

Evan Okulanis

Aug 1, 2024

RISK ADJUSTMENT

Navigating new frontiers in interoperability

Katie Devlin, DHSc, MS, CPHIMS

Jul 30, 2024

PAYMENT INTEGRITY

Podcast: Deploying AI in payment integrity responsibly

Beth Waibel

Jul 29, 2024

RISK ADJUSTMENT

10 tips for a successful commercial risk adjustment program

Katie Sender, MSN, RN, PHN, CRC

Jul 23, 2024

CONSUMER ENGAGEMENT

Navigating new frontiers in member engagement

Leah Dewey

Jul 23, 2024

PAYMENT INTEGRITY

Podcast: Artificial intelligence in payment integrity

Beth Waibel

Jul 22, 2024

PAYMENT INTEGRITY

FRAUD, WASTE, AND ABUSE

Video: Navigating new frontiers in FWA and payment integrity

Erin Rutzler, AHFI, CFE, CHC, CPC

Jul 16, 2024

RISK ADJUSTMENT

Video: Navigating new frontiers in risk adjustment

Katie Sender, MSN, RN, PHN, CRC

Jul 9, 2024

QUALITY AND STARS

Quality Decoded webinar: Preparing for HEDIS MY 2024

Jamison Gillitzer

Jul 3, 2024

QUALITY AND STARS

Video: Navigating new frontiers in quality improvement

Branka Sustic

Jul 2, 2024

QUALITY AND STARS

What to expect from CMS recalculating Star Ratings

Marge Ciancetta

Jun 24, 2024

PAYMENT INTEGRITY

Webinar: Provider billing accuracy and payment trends

Jonathan Edwards

Jun 19, 2024

PAYMENT INTEGRITY

3 strategies for payers to curb increasing medical loss ratios

Michael Jablon

Jun 17, 2024

PAYMENT INTEGRITY

White paper: Getting self-insured employer groups on board with payment integrity

Matthew Hawley

Jun 13, 2024

FRAUD, WASTE, AND ABUSE

FWA Insights: Analysis confirms >$1 million in improper claims

Erin Rutzler, AHFI, CFE, CHC, CPC

Jun 10, 2024

PAYMENT INTEGRITY

Case study: Protecting financial integrity with prepay review solutions

Warren Lesnefsky

Jun 5, 2024

PAYMENT INTEGRITY

Podcast: How to build a valuable coordination of benefits program

Beth Waibel

Jun 3, 2024

ENTERPRISE DATA ANALYTICS

Navigating new frontiers in healthcare: 3 takeaways from CCC24

Brett Arnold

May 29, 2024

CONSUMER ENGAGEMENT

5 steps for proactive member engagement following Medicaid redeterminations

Leah Dewey

May 23, 2024

QUALITY AND STARS

Podcast: New Star Ratings strategies for success in 2025 and beyond

Marge Ciancetta

May 20, 2024

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q1 2024

Erin Rutzler, AHFI, CFE, CHC, CPC

May 14, 2024

PAYMENT INTEGRITY

eBook: How to achieve “total value” in payment integrity

Matthew Hawley

May 8, 2024

QUALITY AND STARS

RISK ADJUSTMENT

White Paper: Executing high-performing interoperability programs to enable clinical data

Katie Devlin, DHSc, MS, CPHIMS

May 2, 2024

RISK ADJUSTMENT

3 key risk adjustment strategies to drive success in 2024

Katie Sender, MSN, RN, PHN, CRC

Apr 18, 2024

PAYMENT INTEGRITY

Webinar: Unlock the “Total Value” of your payment integrity program

Michael Jablon

Apr 16, 2024

QUALITY AND STARS

Webinar: Implications of the 2025 CMS Final Rate Announcement for quality programs

Marge Ciancetta

Apr 11, 2024

PAYMENT INTEGRITY

Case study: Coordination of benefits (COB) results soar for large national plan

Evan Okulanis

Apr 9, 2024

PAYMENT INTEGRITY

Podcast: The "Total Value" approach to payment integrity

Jeff Robinson

Mar 26, 2024

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, AHFI, CFE, CHC, CPC

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 Hay, AHFI, HCAFA

Jan 17, 2024

QUALITY AND STARS

eBook: Closing care gaps in 12 critical areas in 2024

Chad Kinkead

Jan 11, 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 Hay, AHFI, 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, AHFI, CFE, CHC, CPC

Nov 14, 2023

FRAUD, WASTE, AND ABUSE

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

Erin Rutzler, AHFI, CFE, CHC, CPC

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

Steven M. Canfield, D.D.S.

Sep 13, 2023

FRAUD, WASTE, AND ABUSE

Webinar: Finding new schemes with AI and investigative techniques

Erin Rutzler, AHFI, CFE, CHC, CPC

Sep 11, 2023

QUALITY AND STARS

Podcast: Enhancing interoperability for better risk and quality outcomes

Kassi Yozzo

Sep 6, 2023

QUALITY AND STARS

Closing the Gap: Maintaining healthy cholesterol and improving medication adherence

Matt Simon

Aug 31, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q2 2023

Erin Rutzler, AHFI, CFE, CHC, CPC

Aug 29, 2023

PAYMENT INTEGRITY

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

Jeff Robinson

Aug 16, 2023

PAYMENT INTEGRITY

Video: A new approach to prepay coordination of benefits (COB) validation

Naomi Murphy

Aug 14, 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

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