“Minimizing FWA exposure is top-of-mind for all payer organizations, but accomplishing this goal with frequently overburdened special investigative units (SIUs) is challenging,” said Matthew Hawley, executive vice president of payment integrity operations for Cotiviti. “From Cotiviti’s decades of experience working with the top payer organizations, we have developed a unique and powerful approach to prepay waste and abuse prevention. We look forward to discussing how we help plans protect the integrity of their claims payment processes and deliver better outcomes for their members.”
Cotiviti has launched innovative product solutions and partnered with payer clients covering more than 40 million members to implement prepay Claim Pattern Review and postpay FWA Management solutions in 2021 and 2022.
In this session at NHCAA’s Annual Training Conference, Jennifer Putt, CFE, SIU manager for Highmark Wholecare, will join Cotiviti to discuss how combining claims-based and provider-centric reviews, conducted both before and after claims payment, can prevent inappropriate spending while meeting prompt-pay deadlines. The team will share best practices for effectively detecting suspicious patterns, shifting from reactionary to real-time FWA prevention, and leveraging analytics to better identify billing pattern shifts.
This panel will draw on Cotiviti’s work from more than 20 years providing FWA solutions to clients while driving results with prepay and postpay technologies that integrate within its full payment integrity solution suite.
Cotiviti is a platinum sponsor of the NHCAA conference. The session will take place Wednesday, November 16 from 11:30 am–12:30 pm in the Regency Ballroom Q. To learn more, visit booth #301 or visit Cotiviti’s website.
Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. 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, consumer engagement, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.