Cotiviti
VerifiedHealthcare infrastructure platform for payment integrity, risk adjustment, and quality
See all screenshots - Deployment Cloud Based
- Starting price Custom
- Free trial Not offered
- Best for Enterprises
What is Cotiviti?
Cotiviti is a US healthcare technology company that connects data, workflows, and analytics across payment integrity, risk adjustment, quality improvement, and interoperability for health plans. Its Payment Accuracy solutions cover prepay claim editing, coding validation, fraud waste and abuse detection, clinical chart validation, coordination of benefits, and data mining, drawing on cross-payer analytics and benchmarks from claims covering 150 million or more lives.
Cotiviti works with 25 of the 25 largest US health plans and processes more than 3.5 billion claims annually. Beyond payment integrity, its Health Enablement offerings support risk adjustment revenue for Medicare clients and member engagement programs. Pricing is not published; Cotiviti's payment integrity services are commonly structured around performance based or contingency fee arrangements agreed per client contract.
Key Features of Cotiviti
Cotiviti lists 9 documented features, including Prepay claim editing and coding validation, Fraud, waste, and abuse detection and recovery and Clinical chart validation. The list below covers what the product does rather than how it is marketed.
- Prepay claim editing and coding validation
- Fraud, waste, and abuse detection and recovery
- Clinical chart validation
- Coordination of benefits
- Cross-payer claims analytics and benchmarking
- Risk adjustment and HCC coding support
- Quality measure improvement analytics
- Interoperability and healthcare data exchange
- 360 Pattern Review fraud detection service
Cotiviti Pricing
Cotiviti lists 1 plan without published figures. Pricing is quoted on request.
Custom
Custom
Payment integrity services are typically priced on a performance or contingency basis tied to recovered savings; other solutions are quoted per contract. Contact sales for terms.
Cotiviti Specifications
Cotiviti is available on web app. It offers an API.
- Deployment
- Cloud Based
- Billing cycle
- Transaction
- Desktop
- Web App
- Languages
- English
- Built for
- Enterprises
- Support
- Phone
- Integrations
- Health plan claims systems, clinical data sources, coordination of benefits data exchanges
- Public API
- Yes
- Free trial
- No
- Free plan
- No
- Runs in browser
- No
- Customisable
- Yes
- Website
- cotiviti.com
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