Meet the new Cotiviti, a company forged from two industry leaders: Verscend Technologies and Cotiviti Holdings. Offering multidimensional analytic insights, deep market expertise, and high-performance services, we help healthcare organizations transform the economics of healthcare.
Come learn more about the strength in our numbers:
We help health plans maintain payment accuracy during the entire claim lifecycle—from pre-pay clinical claim accuracy to post-pay FWA detection and investigation, and everything in between. We look forward to seeing you there!
Come see us at booth #207, play our “Strength in Numbers” trivia game, and get an Amazon gift card. Sign up for a 10-minute demo or chat with one of our payment accuracy experts while you’re there to be entered into a raffle to win top-of-the-line Bang & Olufsen wireless headphones.
In January, the U.S. Department of Justice issued a memorandum limiting the use of agency guidance documents in affirmative civil enforcement cases. The change includes guidance issued by the U.S. Department of Health and Human Services, Office of Inspector General, as well as the Centers for Medicare & Medicaid Services’ (CMS) Local Coverage Determinations (LCDs) and Medicare billing manuals. This session explores these changes, helping participants navigate appropriate and enforceable review resources to use and the benefits and pitfalls of creating plan-developed medical policies.
Manager of Fraud, Waste, and Abuse, Cotiviti
Gerry Petrowski, CPC
Supervisor, Medical Review, Cotiviti
Payers have understood the value proposition for prospectively addressing fraud, waste, and abuse in healthcare for well over a decade. However, adoption has been slow at best and even non-existent in some cases. The challenges are real: clinical analyst resources and operational cost constraints; prompt payment guidelines and penalties; provider abrasion; and competing interests among network management, SIUs and claims operations. Certain myths standing in the way of overcoming many of these challenges that need to be dispelled. Join our industry experts as they discuss the different approaches that can improve your pre-payment model while coordinating the competing priorities in your health plan.
John Neumann, RN
Clinical Consultant, Cotiviti
Erin Picton, AHFI, CFE
Director of Fraud, Waste and Abuse, Cotiviti