The business challenges listed below led the profiled company to evaluate and ultimately select Cotiviti.
Organizational challenges that require payment integrity solutions from vendors:
- A need for reducing medical costs
- A need to avoid more improper claims before payment
- A need to supplement other vendors around their claim payment process
Vendors they supplemented and/or replaced by choosing Cotiviti:
Why they chose Cotiviti over other vendors:
- Cotiviti has a greater focus on pre-pay accuracy
The key features and functionalities of Cotiviti used by the surveyed company are as follows.
Cotiviti Payment Accuracy solution(s) their organization uses:
- Prospective Claim Accuracy for automated claim editing accuracy
- Retrospective Claim Accuracy for post-pay audit and recovery
- Clinical Chart Validation for post-pay DRG medical record review
- Fraud, Waste and Abuse solution(s)
The surveyed small business healthcare company has used Cotiviti’s payment accuracy solutions for over 3 years.
The results listed below were achieved with Cotiviti by the surveyed small business healthcare company.
Key benefits experienced since working with the Cotiviti payment accuracy solutions:
- Increased pre-pay savings by avoiding improper claims payment
- Improved accuracy of appropriate provider payments
Level of agreement with the following in regard to Cotiviti:
- Is excellent at configuring the solutions to the health plan’s specific systems and payment policies: strongly agree
- Helps to lessen the abrasion of their integrity programs on network providers: agree
The surveyed small business healthcare company confirmed that Cotiviti’s sole focus on health plans is highly valuable to their organization.
The following Cotiviti capabilities are rated in terms of how differentiated Cotiviti is when compared to the competition:
- Greater cost savings: highly differentiated
- Accuracy: highly differentiated
- Ability to understand business needs: highly differentiated
- Time-to-value: differentiated