Latest news with #Cotiviti
Yahoo
29-05-2025
- Business
- Yahoo
Cotiviti GOV Services Awarded Contracts for CMS Recovery Audit Contractor (RAC) Region 3, Region 4, and Region 5
Contract will support CMS in safeguarding payment integrity for Medicare fee-for-service beneficiaries SALT LAKE CITY, May 29, 2025--(BUSINESS WIRE)--Cotiviti GOV Services, LLC, a long-standing partner of Federal Government healthcare agencies and programs for more than 20 years, has been named by the Centers for Medicare & Medicaid Services (CMS) as the designated Recovery Audit Contractor (RAC) for Region 3, Region 4, and Region 5. These three contracts, awarded through a competitive procurement process, will support postpay review of Medicare claims in these regions to efficiently identify and correct overpayments and underpayments made to healthcare providers with a focus on the quality, accuracy, and transparency of reviews; recovery of improper payments; and minimizing provider burden. "We are honored to continue our long-standing partnership with CMS by delivering our advanced technology, data analytics, and specialized expertise to support the RAC Program, as well as continue to identify other opportunities to invest in our solutions and partnerships in the government market," said Chris Coloian, executive vice president of Cotiviti, Inc. and general manager of Cotiviti GOV Services, LLC. CMS RAC Region 3 comprises eight states in the Southeast and two territories, while Region 4 comprises 17 states in the West and Mid-Atlantic, Washington, D.C., and three territories. As the incumbent for these regions, Cotiviti will continue to conduct postpay review of Medicare fee-for-service claims. RAC Region 5, which will transition from the previous contractor to Cotiviti GOV Services, comprises all fee-for-service claims nationwide for durable medical equipment and prosthetic, orthotics, and supplies (DMEPOS) as well as home health and hospice (HH&H). About Cotiviti Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti's solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit About Cotiviti GOV Services Cotiviti GOV Services' payment integrity solutions empower government agencies in the prevention and pursuit of errors, fraud, waste, and abuse, spanning the entire claim payment spectrum. These solutions enable both public and private payers in the continuing shift from postpay recovery of improper payments to automated prepay identification and prevention of improper payments for inappropriately coded claims to increase efficiency and protect beneficiaries. Cotiviti GOV Services delivers multiplatform payment integrity and quality improvement solutions that drive effective and efficient management and stewardship of mission-critical programs, supporting agencies such as the Centers for Medicare & Medicaid Services (CMS), Veterans Health Administration (VHA), Centers for Disease Control and Prevention (CDC), and the Defense Health Agency (DHA). View source version on Contacts Media Contact: Corey PatchkofskyAria Marketing for Cotiviticpatchkofsky@ 203-710-2296 Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
12-05-2025
- Business
- Yahoo
Cotiviti Named Highest-Designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix® Assessment 2025
Distinction marks third consecutive year Cotiviti has been positioned as a Leader in this category SALT LAKE CITY, May 12, 2025--(BUSINESS WIRE)--Cotiviti, a leader in data-driven healthcare solutions, has been named the highest-designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix® Assessment 2025. This recognition is a reflection of the combined market impact, vision, and capabilities delivered by Cotiviti's Payment Accuracy solutions. "As they strive to eliminate waste and ensure the accuracy and quality of their claims payments, health plans are increasingly looking for a payment accuracy partner that can deliver the breadth, depth, and scale they require across their numerous programs," said Emad Rizk, M.D., president and CEO of Cotiviti. "This achievement underscores Cotiviti's unwavering commitment to both prepayment and postpayment integrity as well as our market-leading client services, which eliminated over $9.5 billion in payment waste from the healthcare system in 2024 through the prevention of improper claims, which can enable those funds to be redirected toward appropriate member care and populations in need." "With healthcare fraud and billing errors costing the U.S. system billions of dollars annually, payers are intensifying efforts to adopt proactive payment integrity strategies that span the full claims lifecycle," said Ankur Verma, vice president at Everest Group. "Cotiviti brings a comprehensive breadth of experience across payer types and addresses both pre and postpay needs through a comprehensive solution suite. Its clients cite strong value, robust relationship management, and a deep commitment to performance as key differentiators. Investments in product innovation and the formalization of an AI Center of Excellence further aided in its positioning as a Leader in Everest Group's Payment Integrity Solutions PEAK Matrix® Assessment 2025." Everest Group's PEAK Matrix® is a globally recognized assessment that evaluates organizations based on key factors such as vision, capabilities, functionality, talent availability, market success, impact, and cost-effectiveness. Cotiviti has been recognized as a Leader in payment integrity solutions for each of the three years that this assessment has been published. This year, the company earned the position of the highest-designated Leader, reflecting its continuous innovation, commitment to accuracy, and proven success in delivering value to clients. Cotiviti has been a leader in payment integrity for over 25 years and serves more than 100 payer clients with Payment Accuracy solutions, including top national health plans, regional and community plans, Blue Cross Blue Shield Plans, third-party administrators, CMS, and state Medicaid agencies. "By offering full-service solutions across the payment continuum, driven by clinical expertise and advanced technologies including artificial intelligence and natural language processing, Cotiviti delivers total value, meaningful innovation, and deep expertise to each of our customers," said Christopher Coloian, executive vice president of revenue and growth for Cotiviti. "This recognition highlights what truly distinguishes Cotiviti: our differentiated technology, content and service model that underpins our clients' ability to administer benefits and accurately pay for services for their members." Cotiviti's Payment Accuracy solutions include prepay claim editing and coding validation; fraud, waste, and abuse prevention and recovery; clinical coding validation; coordination of benefits; and data mining. Prepay claim editing customers also have access to Cotiviti's industry-leading cross-payer analytics and benchmarks, delivering claim and provider insights to empower health plans to make more informed payment policy decisions based on what's happening across the entire market. The Everest Group report offering an overview of Cotiviti's payment integrity solutions is available on Cotiviti's website for health plan professionals to download and read. About Cotiviti Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti's solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit Disclaimer Licensed extracts taken from Everest Group's PEAK Matrix® Reports, may be used by licensed third parties for use in their own marketing and promotional activities and collateral. Selected extracts from Everest Group's PEAK Matrix® reports do not necessarily provide the full context of our research and analysis. All research and analysis conducted by Everest Group's analysts and included in Everest Group's PEAK Matrix® reports is independent and no organization has paid a fee to be featured or to influence their ranking. To access the complete research and to learn more about our methodology, please visit Everest Group PEAK Matrix® Reports. About Everest Group Everest Group is a leading global research firm helping business leaders make confident decisions. Everest Group's PEAK Matrix® assessments provide the analysis and insights enterprises need to make critical selection decisions about global services providers, locations, and products and solutions within various market segments. Likewise, providers of these services, products, and solutions, look to the PEAK Matrix® to gauge and calibrate their offerings against others in the industry or market. Find further details and in-depth content at View source version on Contacts Media Contact: Corey PatchkofskyAria Marketing for Cotiviticpatchkofsky@ 203-710-2296 Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
12-05-2025
- Business
- Yahoo
Cotiviti Named Highest-Designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix® Assessment 2025
Distinction marks third consecutive year Cotiviti has been positioned as a Leader in this category SALT LAKE CITY, May 12, 2025--(BUSINESS WIRE)--Cotiviti, a leader in data-driven healthcare solutions, has been named the highest-designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix® Assessment 2025. This recognition is a reflection of the combined market impact, vision, and capabilities delivered by Cotiviti's Payment Accuracy solutions. "As they strive to eliminate waste and ensure the accuracy and quality of their claims payments, health plans are increasingly looking for a payment accuracy partner that can deliver the breadth, depth, and scale they require across their numerous programs," said Emad Rizk, M.D., president and CEO of Cotiviti. "This achievement underscores Cotiviti's unwavering commitment to both prepayment and postpayment integrity as well as our market-leading client services, which eliminated over $9.5 billion in payment waste from the healthcare system in 2024 through the prevention of improper claims, which can enable those funds to be redirected toward appropriate member care and populations in need." "With healthcare fraud and billing errors costing the U.S. system billions of dollars annually, payers are intensifying efforts to adopt proactive payment integrity strategies that span the full claims lifecycle," said Ankur Verma, vice president at Everest Group. "Cotiviti brings a comprehensive breadth of experience across payer types and addresses both pre and postpay needs through a comprehensive solution suite. Its clients cite strong value, robust relationship management, and a deep commitment to performance as key differentiators. Investments in product innovation and the formalization of an AI Center of Excellence further aided in its positioning as a Leader in Everest Group's Payment Integrity Solutions PEAK Matrix® Assessment 2025." Everest Group's PEAK Matrix® is a globally recognized assessment that evaluates organizations based on key factors such as vision, capabilities, functionality, talent availability, market success, impact, and cost-effectiveness. Cotiviti has been recognized as a Leader in payment integrity solutions for each of the three years that this assessment has been published. This year, the company earned the position of the highest-designated Leader, reflecting its continuous innovation, commitment to accuracy, and proven success in delivering value to clients. Cotiviti has been a leader in payment integrity for over 25 years and serves more than 100 payer clients with Payment Accuracy solutions, including top national health plans, regional and community plans, Blue Cross Blue Shield Plans, third-party administrators, CMS, and state Medicaid agencies. "By offering full-service solutions across the payment continuum, driven by clinical expertise and advanced technologies including artificial intelligence and natural language processing, Cotiviti delivers total value, meaningful innovation, and deep expertise to each of our customers," said Christopher Coloian, executive vice president of revenue and growth for Cotiviti. "This recognition highlights what truly distinguishes Cotiviti: our differentiated technology, content and service model that underpins our clients' ability to administer benefits and accurately pay for services for their members." Cotiviti's Payment Accuracy solutions include prepay claim editing and coding validation; fraud, waste, and abuse prevention and recovery; clinical coding validation; coordination of benefits; and data mining. Prepay claim editing customers also have access to Cotiviti's industry-leading cross-payer analytics and benchmarks, delivering claim and provider insights to empower health plans to make more informed payment policy decisions based on what's happening across the entire market. The Everest Group report offering an overview of Cotiviti's payment integrity solutions is available on Cotiviti's website for health plan professionals to download and read. About Cotiviti Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti's solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit Disclaimer Licensed extracts taken from Everest Group's PEAK Matrix® Reports, may be used by licensed third parties for use in their own marketing and promotional activities and collateral. Selected extracts from Everest Group's PEAK Matrix® reports do not necessarily provide the full context of our research and analysis. All research and analysis conducted by Everest Group's analysts and included in Everest Group's PEAK Matrix® reports is independent and no organization has paid a fee to be featured or to influence their ranking. To access the complete research and to learn more about our methodology, please visit Everest Group PEAK Matrix® Reports. About Everest Group Everest Group is a leading global research firm helping business leaders make confident decisions. Everest Group's PEAK Matrix® assessments provide the analysis and insights enterprises need to make critical selection decisions about global services providers, locations, and products and solutions within various market segments. Likewise, providers of these services, products, and solutions, look to the PEAK Matrix® to gauge and calibrate their offerings against others in the industry or market. Find further details and in-depth content at View source version on Contacts Media Contact: Corey PatchkofskyAria Marketing for Cotiviticpatchkofsky@ 203-710-2296 Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Business Wire
12-05-2025
- Business
- Business Wire
Cotiviti Named Highest-Designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix
SALT LAKE CITY--(BUSINESS WIRE)-- Cotiviti, a leader in data-driven healthcare solutions, has been named the highest-designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix ® Assessment 2025. This recognition is a reflection of the combined market impact, vision, and capabilities delivered by Cotiviti's Payment Accuracy solutions. 'Cotiviti brings a comprehensive breadth of experience across payer types and addresses both pre and postpay needs through a comprehensive solution suite." Share 'As they strive to eliminate waste and ensure the accuracy and quality of their claims payments, health plans are increasingly looking for a payment accuracy partner that can deliver the breadth, depth, and scale they require across their numerous programs,' said Emad Rizk, M.D., president and CEO of Cotiviti. 'This achievement underscores Cotiviti's unwavering commitment to both prepayment and postpayment integrity as well as our market-leading client services, which eliminated over $9.5 billion in payment waste from the healthcare system in 2024 through the prevention of improper claims, which can enable those funds to be redirected toward appropriate member care and populations in need.' 'With healthcare fraud and billing errors costing the U.S. system billions of dollars annually, payers are intensifying efforts to adopt proactive payment integrity strategies that span the full claims lifecycle,' said Ankur Verma, vice president at Everest Group. 'Cotiviti brings a comprehensive breadth of experience across payer types and addresses both pre and postpay needs through a comprehensive solution suite. Its clients cite strong value, robust relationship management, and a deep commitment to performance as key differentiators. Investments in product innovation and the formalization of an AI Center of Excellence further aided in its positioning as a Leader in Everest Group's Payment Integrity Solutions PEAK Matrix ® Assessment 2025.' Everest Group's PEAK Matrix ® is a globally recognized assessment that evaluates organizations based on key factors such as vision, capabilities, functionality, talent availability, market success, impact, and cost-effectiveness. Cotiviti has been recognized as a Leader in payment integrity solutions for each of the three years that this assessment has been published. This year, the company earned the position of the highest-designated Leader, reflecting its continuous innovation, commitment to accuracy, and proven success in delivering value to clients. Cotiviti has been a leader in payment integrity for over 25 years and serves more than 100 payer clients with Payment Accuracy solutions, including top national health plans, regional and community plans, Blue Cross Blue Shield Plans, third-party administrators, CMS, and state Medicaid agencies. 'By offering full-service solutions across the payment continuum, driven by clinical expertise and advanced technologies including artificial intelligence and natural language processing, Cotiviti delivers total value, meaningful innovation, and deep expertise to each of our customers,' said Christopher Coloian, executive vice president of revenue and growth for Cotiviti. 'This recognition highlights what truly distinguishes Cotiviti: our differentiated technology, content and service model that underpins our clients' ability to administer benefits and accurately pay for services for their members.' Cotiviti's Payment Accuracy solutions include prepay claim editing and coding validation; fraud, waste, and abuse prevention and recovery; clinical coding validation; coordination of benefits; and data mining. Prepay claim editing customers also have access to Cotiviti's industry-leading cross-payer analytics and benchmarks, delivering claim and provider insights to empower health plans to make more informed payment policy decisions based on what's happening across the entire market. The Everest Group report offering an overview of Cotiviti's payment integrity solutions is available on Cotiviti's website for health plan professionals to download and read. About Cotiviti Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti's solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit Disclaimer Licensed extracts taken from Everest Group's PEAK Matrix ® Reports, may be used by licensed third parties for use in their own marketing and promotional activities and collateral. Selected extracts from Everest Group's PEAK Matrix ® reports do not necessarily provide the full context of our research and analysis. All research and analysis conducted by Everest Group's analysts and included in Everest Group's PEAK Matrix ® reports is independent and no organization has paid a fee to be featured or to influence their ranking. To access the complete research and to learn more about our methodology, please visit Everest Group PEAK Matrix ® Reports. Everest Group is a leading global research firm helping business leaders make confident decisions. Everest Group's PEAK Matrix ® assessments provide the analysis and insights enterprises need to make critical selection decisions about global services providers, locations, and products and solutions within various market segments. Likewise, providers of these services, products, and solutions, look to the PEAK Matrix ® to gauge and calibrate their offerings against others in the industry or market. Find further details and in-depth content at
Yahoo
05-05-2025
- Business
- Yahoo
Cotiviti Selects the Casepoint Platform for Its Innovative Technology
OPEXUS + Casepoint signs a multi-year contract with Cotiviti to automate the company's internal and external litigation-related processes with a secure and unified legal hold platform. WASHINGTON, May 5, 2025 /PRNewswire/ -- Cotiviti, a leader in data-driven healthcare solutions, has selected the Casepoint legal hold management solution from OPEXUS + Casepoint to support internal investigations and litigation workflows within a single, secure platform. OPEXUS + Casepoint, the trusted leader in regulatory and compliance workflows across corporate and government enterprises, today announced that it has signed a multi-year contract with Cotiviti to provide its powerful, end-to-end legal hold management and eDiscovery platform to the technology and analytics company. Cotiviti empowers healthcare organizations to deliver better care at a lower cost with its robust payment accuracy, risk adjustment, quality improvement, and consumer engagement solutions. "As our organization continued to grow, we needed a single, secure, and unified legal hold platform to help manage legal matters," said Brett Magun, General Counsel for Cotiviti. "After exploring top legal hold solutions in the U.S., we ultimately selected Casepoint and look forward to a successful relationship." "We are thrilled to collaborate with Cotiviti as they implement Casepoint's end-to-end legal hold management and eDiscovery platform," said Chris Kruse, Chief Revenue Officer at OPEXUS + Casepoint. "This collaboration underscores our commitment to providing enterprise organizations with powerful technology that significantly reduces legal risk while enhancing defensibility. Cotiviti will benefit from our intuitive templates, advanced AI capabilities, and automation features that streamline complex processes and improve operational efficiency. What makes this particularly exciting is our shared vision for technology that's not only sophisticated but genuinely user-friendly. At OPEXUS + Casepoint, we pride ourselves on being more than just a software provider — we're a true partner invested in our customers' success in navigating today's complex legal landscape." Cotiviti selected Casepoint based on its proven track record of working with large enterprises, its platform's ease of use, its ability to preserve held documents in place with integrated eDiscovery features, and its strong security qualifications. Features like automatic preservation and the ability to easily look at collected data will help streamline and ensure compliance. Learn more about Cotiviti's solutions in healthcare technology and data analytics. About OPEXUS + Casepoint OPEXUS + Casepoint is the trusted leader in regulatory and compliance workflows across corporate and government enterprises. The company was formed through the 2025 merger of OPEXUS, a leading provider of government process management software, and Casepoint, the industry leader in corporate and government data discovery technology for litigation, investigations, and data compliance. With solutions deployed in both large commercial organizations and government institutions worldwide, OPEXUS + Casepoint brings modern technology with AI, analytics, and automation to drive operational excellence for corporations and government agencies. For more information, visit and About Cotiviti Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti's solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit Media ContactCarolyn DepkoPlat4orm PRMedia Relations Managercarolyn@ 908-565-3709 View original content to download multimedia: SOURCE Casepoint
