Cotiviti

As we continue to witness the devastating impacts of Hurricane Helene across the southeast U.S. and brace for the arrival of Hurricane Milton, our hearts are with those affected. At Cotiviti, the safety and well-being of our employees remain our top priority. Our HR team has been actively reaching out to ensure everyone is safe and aware of the resources available. In response, Cotiviti Cares will be supporting recovery efforts through several incredible organizations that have mobilized to address the most imminent needs and recovery efforts: ? Direct Relief: Providing emergency medical supplies and transportation support ? Feeding America: Supplying food and essentials to affected communities ? GlobalGiving: Delivering emergency supplies to displaced people and animals ? CARE: Offering cash assistance for families' essential needs and long-term recovery ? Habitat for Humanity International: Helping rebuild homes and communities We’re also launching an employee matching gift campaign through Americares to support health needs in the hardest-hit communities. Finally, we encourage employees to use their Volunteer Time Off (VTO) to assist in local recovery efforts. Together, we can make a difference.

Holistic payment integrity programs should perform beyond DIY models and low-hanging fruit. For the best long-term value, health plans need innovative programs to match their specific needs using comprehensive solutions that integrate with existing systems. View Cotiviti's on-demand webinar and learn the Total Value approach to your payment integrity program. Our experts will walk through how to: ?? Achieve sustainable medical cost reduction with expert-derived content and solutions ?? Realize long-term value with a differentiated service model and integrated solution breadth ?? Gain transparency and confidence in your payment integrity programs with clinically led client services and analytic insights Watch now and subscribe on YouTube. https://bit.ly/3K2aP1a Michael Jablon #payments #HealthPlans

The three largest U.S. drug distributors have agreed to pay $300 million to settle lawsuits brought by health plans over the opioid crisis. These lawsuits claim that the distributors' actions forced plans to cover the cost of overprescribed opioids and treatment for opioid use disorder. While the companies do not admit wrongdoing, the settlement will provide restitution to health plans, including Medicare and Medicaid operators. https://bit.ly/4dUmyMd Healthcare Dive #HealthPlans #payments

Skilled nursing facility (SNF) and inpatient rehabilitation facility (IRF) claim reviews are complex, requiring the expert support of skilled auditors. Cotiviti's Amy Palilonis Carleton explains the basics of SNF and IRF claims and why an extra layer of review is vital for health plans. https://bit.ly/47DSHW6 #HealthPlans #payments #healthcare

As we celebrate Hispanic Heritage Month, we are spending time recognizing the profound impact Latino and Hispanic individuals have had across various fields—from the arts and sciences to sports and leadership. Today, we’re highlighting Gabriela Sabatini, the legendary Argentine tennis player who became one of the sport’s most accomplished athletes. Known for her grace on the court and fierce competitive spirit, Sabatini captured the hearts of fans worldwide, winning numerous titles, including the 1990 U.S. Open. Beyond her athletic achievements, she has used her platform to inspire young athletes and support charitable causes, cementing her legacy as a global ambassador for the sport.

With CMS about to release the much-anticipated 2025 Star Ratings, Cotiviti's Marge Ciancetta explains what you'll learn during our upcoming webinar on 10/24. Read our latest LinkedIn newsletter:

Improving coding accuracy is vital for health plans to deliver value in risk adjustment while meeting the increasing demands of regulatory scrutiny. As healthcare requirements evolve, plans must stay informed and adopt proven strategies to maintain high coding standards. Join us on October 17 at 1:30 pm ET for a RISE webinar where Cotiviti experts review vital areas of coding improvement. Topics include: ?? Recent coding updates ?? Common errors ?? Best practices for enhancing training and QA processes Register today to save your spot and ensure you’re equipped to handle the latest industry challenges. https://bit.ly/4gx626I #HealthPlans #healthcare #RiskAdjustment

September marks 35 years of National Recovery Month, a time to reflect on advancements in substance use disorder (SUD) treatment and coverage. Over the years, legislative and regulatory efforts have expanded access to care, recognizing SUD as a chronic condition requiring long-term support. In 2024, payer coverage continues to evolve, ensuring individuals have the resources they need for recovery and sustained wellness. https://bit.ly/4e6B6si HealthLeaders #HealthPlans #payments

We have not posted a Job of the Week for a bit. This week we'd like to feature a VP of Sales role that we are looking to fill. If you have experience selling healthcare software solutions and services to Payer clients, especially in Payment Accuracy solutions, this is a great opportunity to join a growing team and company. We offer state of the art, highly regarded products and services, and an excellent working environment with the chance to collaborate with industry experts and thought leaders. Please see job details below, where you can apply directly. #Sales #healthcare #paymentaccuracy ?https://lnkd.in/etQsuiqm

NCQA has finalized changes for HEDIS Measurement Year 2025, signaling significant digital measurement and health equity updates. These include the retirement of several hybrid measures, the introduction of new blood pressure measures, and the removal of ICD-9 codes from measurement value sets. Cotiviti's Samantha Davis explains that with NCQA aiming for fully digital measurement by 2030, health plans must now adjust strategies. Explore Cotiviti's recommendations to prepare for these impactful updates. https://hubs.ly/Q02R7nVS0 #HEDSI #HealthPlans #healthcare