TechValidate Research on Cotiviti

These pages present data that TechValidate has sourced via direct research with verified customers and users of Cotiviti. TechValidate stands behind the authenticity of all published data. Learn more »



102 Customers Surveyed

594 Data Points Collected

54 Published TechFacts

11 Published Charts

6 Published Case Studies



Selected Research Highlights


Cotiviti Customer Testimonial

[We have seen with Cotiviti] Increased prepay savings due to the large breadth and depth of the claims auditing solutions, as well as in the retrospective arena where gaps in the primary vendors program allow edits to fail.

Manager of Claims Operations, Large Enterprise Healthcare Company

Cotiviti Customer Research

How valuable to your organization is Cotiviti’s sole focus on health plans?

Highly valuable: 47%
Extremely valuable: 25%
Valuable: 25%
Not valuable: 3%

Cotiviti Case Study

Small Business Healthcare Company

Introduction

This case study of a small business healthcare company is based on a January 2020 survey of Cotiviti customers by TechValidate, a 3rd-party research service. The profiled company asked to have their name blinded to protect their confidentiality.

Challenges

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:

  • LexisNexis

Why they chose Cotiviti over other vendors:

  • Cotiviti has a greater focus on pre-pay accuracy

Use Case

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.

Results

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

Cotiviti Customer Testimonial

We have generated significant benefit savings for our members and have done it with minimal internal resources and abrasion to our providers.

VP of Payment Integrity, Large Enterprise Healthcare Company

Cotiviti Case Study

Medium Enterprise Healthcare Company

Introduction

This case study of a medium enterprise healthcare company is based on a December 2019 survey of Cotiviti customers by TechValidate, a 3rd-party research service. The profiled company asked to have their name blinded to protect their confidentiality.

“The new case management system has greatly enhanced the SIU’s ability to utilize investigation results for regulatory and internal reporting. The Cotiviti team was great during the implementation and continues to assist with our efforts to improve the tool.”

Challenges

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 to avoid more improper claims before payment

Vendors they supplemented and/or replaced by choosing Cotiviti:

  • We didn’t have a payment integrity solution prior to Cotiviti

Use Case

The following key features and functionalities of Cotiviti are used by the surveyed company.

Cotiviti Payment Accuracy solution(s) used by the surveyed organization:

  • Fraud, Waste and Abuse solution(s)

The surveyed company has used Cotiviti’s payment accuracy solutions for over 3 years.

Results

The surveyed medium enterprise healthcare company achieved the following results with Cotiviti.

Key benefits experienced since working with the Cotiviti payment accuracy solutions:

  • Identified and addressed more patterns of fraud, waste and abuse

Level of agreement with the following in regard to Cotiviti:

  • Is more than a vendor. They are a partner, providing deep consultative support to help meet their business needs: agree
  • Is responsive to their support needs: agree
  • Is a neutral partner with singular focus on health plan results: agree

The surveyed medium enterprise 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:

  • Subject matter expertise: differentiated
  • Ability to understand business needs: highly differentiated
  • Time-to-value: highly differentiated

Cotiviti Customer Research

What organizational challenges do you have that require payment integrity solutions from vendors?

A need to avoid more improper claims before payment
90%
A need for reducing medical costs
69%
A need to supplement other vendors around our claim payment process
26%
Other
5%


More to Explore



About Cotiviti

Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.

Cotiviti Website   Cotiviti Website