Payment Accuracy & Integrity Solutions 2023
24 October 23
| Joe VanDeGraaff and Ruirui Sun
Payers take on financial risk for members and pay for healthcare expenditures based on various plans and reimbursement types. Due to the complexity of reimbursement contracts, many factors (e.g., coding and billing errors, fraud, waste) can contribute to payers sometimes underpaying or overpaying provider organizations. Payment accuracy and integrity solutions help payers make accurate payments and recover losses when overpayments and fraud occur. This report—KLAS’ first on this market—aims to identify the main capabilities these solutions provide and show early findings on customer satisfaction with vendors’ performance.
Note: Research in this report is based on feedback from interviewed payer customers. This report is not intended to compare measured vendors’ technological capabilities.
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Director
Loyalty
There are many concepts that Cotiviti offers that we have historically...
Manager
Operations
Our implementation of Cotiviti Payment Accuracy Solutions was very...
VP/Other Executive
Culture, Product, Value
I wouldn't buy Cotiviti Payment Accuracy Solutions again. Frankly, I...
VP/Other Executive
Culture
We are working through charges with Cotiviti. It took some work for us...
VP/Other Executive
Product
Cotiviti Payment Accuracy Solutions is kind of clunky. There are a lot...
VP/Other Executive
Loyalty, Operations
We had a bad implementation of Cotiviti Payment Accuracy Solutions....
VP/Other Executive
Relationship
We need Cotiviti to be more flexible on the criteria that they use to...
VP/Other Executive
Relationship
A lot of vendors do post-pay, so we can get that service from...
VP/Other Executive
Operations
The implementation was good. So far, the system is finding money, so...
COO
Product
At the end of the day, Cotiviti's solution works well for an...