Cotiviti

AI has the potential to transform value-based care, but success requires more than new technology. Join Cotiviti experts for a two-part webinar series exploring practical AI applications, the role of data readiness, and real-world strategies to improve population health outcomes and financial performance. You'll learn: • How AI is helping healthcare organizations improve value-based care performance • Why data quality, governance, and interoperability matter • Where emerging agentic AI capabilities can create measurable value Register today for the webinars: https://hubs.ly/Q04sGQzT0

🚨 Errors don't start at the invoice—they start upstream. We're heading to the GBS Select Summit & SSOW Conference to talk about why finance and procurement leaders are shifting from recovery to prevention, and how greater visibility can help reduce financial leakage before transactions are finalized. Stop by Booth 407 to connect with our team and learn how organizations are taking a more proactive approach to procure-to-pay management. 📍 Booth 407 | 📅 September 13–17 | San Diego

Plan Preview is one of the few moments in the Star Ratings calendar when the number in front of you isn't final yet. The worst response is panic. The best response is action. Cotiviti AVP of Quality and Stars Operations Taylor H. shares practical guidance for Stars leaders navigating Plan Preview, including why it's critical to validate CMS results, identify discrepancies quickly, and make the most of the limited review window. A Plan Preview score isn't a verdict. It's a checkpoint. The organizations that succeed are the ones that use this moment to assess, respond, and refine their strategy for the year ahead. Stay tuned for more tomorrow!

As health plans navigate major transformation in quality measurement, success will depend on more than measuring quality. It will depend on having the right infrastructure to turn quality data into meaningful action. That's why Cotiviti is proud to sponsor the NCQA Health Innovation Summit 2026. Throughout the conference, we invite you to join our dedicated in-booth conversations focused on the topics shaping the future of quality. 📍 Atlanta, GA 📅 October 4-7, 2026 Let's connect and explore what's possible together.

Coordination of benefits (COB) has always been treated as a retrospective process. But what if health plans could prevent issues before a claim is ever submitted? Now they can with Proactive COB. Watch as EVP of Data Mining and COB Naomi Murphy, JD and Vice President of Product Management Matthew Herbein explore how Proactive COB connects data, AI, and smarter interventions to empower health plans to identify other coverage earlier, determine the correct order of benefits faster, and move from recovery to prevention. The result: fewer payment errors, less administrative burden, and a better experience for payers, providers, and members. Learn how it works: https://hubs.ly/Q04sWzSd0

As healthcare continues to generate more data, the real opportunity isn't simply collecting more information. It's building the infrastructure that helps the right information reach the right decision at the right time. And this is especially important when it comes to coordination of benefits (COB) Cotiviti's Proactive COB does exactly that. As MedCity News reports, Proactive COB relies on member enrollment data rather than waiting for a medical claim to be submitted—so payers can determine the correct order of benefits much sooner. It's not only better for payers, but reduces administrative burden for providers and members, too. Read the article: https://lnkd.in/eU3-dvTu

AI is creating new opportunities across healthcare, but the biggest impact comes when it amplifies human expertise, not replaces it. We're proud to be featured in a new blog from the Healthcare Leadership Council (HLC) examining how AI paired with clinical expertise is driving better outcomes for payers, providers, and consumers. Read our thoughts from HLC member Christopher Coloian, MHA, Cotiviti's Chief Strategy Officer, and see how we're deploying AI and machine learning to prevent errors in coordination of benefits, stop fraud and abuse, and more. ➡️ https://lnkd.in/eiQsM-7D

Coordination of benefits issues often aren't discovered until after claims have been paid, creating costly recovery efforts and administrative burden. That's why we're extending COB intervention upstream with Proactive COB. This new COB capability helps health plans identify other health insurance coverage and determine benefit primacy at enrollment—before claims are submitted. It's better for the payer, it's better for the provider, and it's better for the member. By combining AI-enabled analysis, validated member data, and decades of COB expertise, Proactive COB shifts the focus from recovery to prevention and helps improve payment accuracy from the start. Learn how health plans can reduce administrative waste, lower abrasion, and prevent avoidable payment errors before they occur.

The conversation around home health fraud often centers on ensuring compliance through postpay audits—but that isn't enough. In a new article for MedCity News, Cotiviti SVP of Payment Integrity Operations Erin Rutzler argues that today’s fraud tactics demand a broader strategy focused on preventing improper payments before they occur. From AI-generated documentation to increasingly complex billing schemes, bad actors are finding new ways to exploit vulnerabilities in the healthcare system. Learn key areas where payers should strengthen their efforts, including: ➡️ Advanced AI-backed analytics ➡️ Automated prepay editing ➡️ Cross-payer data aggregation ➡️ Enhanced provider education Read Erin’s full article in MedCity News: https://lnkd.in/esRXbBYR

Every industry needs infrastructure that makes better decisions earlier. Healthcare is no different. Payers looking for an advantage aren't just identifying errors. They're redesigning when decisions happen. Earlier data. Earlier intelligence. Earlier action. Our latest eBook explores why real-time, prepay infrastructure is becoming the new operating standard in health plan payment operations. 📘 Read it here: https://hubs.ly/Q04sL6Pl0