Cotiviti Helps Control Inaccuracy Of Payments

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According to market reports, the healthcare costs in the United States grew 5% annually over the past ten year period to $3.2 trillion in 2015. The Centers for Medicare & Medicaid Services (CMS) expects the healthcare costs to continue to grow at 6% annually through 2024. Of the $3.2 trillion spend in the industry, the US federal government estimates that inaccurate provider claim submissions ranged from 3%-10%. Cotiviti Holdings is hoping to reduce this inaccuracy through its analytical engine.

Cotiviti Holding’s Offerings

Atlanta-based Cotiviti (COTV) offers analytics-driven payment accuracy solutions focused on the healthcare sector. It leverages its technology platform, a configurable analytics engine, and proprietary information assets and expertise to provide its clients with improved payment accuracy. It was founded in 2014 through the merger of Connolly Superholdings, Inc. and iHealth Technologies, Inc. Connolly Superholdings was a leader in retrospective payment accuracy solutions for the healthcare and retail sectors and iHealth Technologies was a leader in prospective payment accuracy solutions for the healthcare sector. After the merger, the combined entity rebranded itself as Cotiviti Holdings. Today, Cotiviti claims that it helps Medicare Advantage, private insurers, Medicaid Managed Care organizations and other clients capture more than $3 billion annually through improved accuracy in handling claims and compliance.

The merger also helped Cotiviti grow into payment accuracy solutions for the retail market. While healthcare remains its focus, it also offers solutions to retailers to process and validate high volumes of transactions with disparate suppliers on varying terms. It works with retail clients in the United States, Canada, and the United Kingdom to process their negotiated allowances, concessions, rebates, and other incentives associated with merchandise procurement, logistics, and other service transactions.

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More investigation and analysis of Unicorn companies can be found in my latest Entrepreneur Journeys book, Billion Dollar Unicorns. Unicorns will also be discussed with some special guests during our 1M/1M Roundtable programs over the next few weeks. To be a part of the conversation, please register here. The term Unicorn was coined in a TechCrunch article by Aileen Lee of Cowboy Ventures.

Sramana Mitra is the founder of One Million by One Million (1M/1M), a global virtual incubator that aims to help one million entrepreneurs globally to reach $1 million in revenue and beyond. She is a Silicon Valley entrepreneur and strategy consultant, she writes the blog Sramana Mitra On Strategy, and is author of the Entrepreneur Journeys book series and Vision India 2020. From 2008 to 2010, Mitra was a columnist for Forbes. As an entrepreneur CEO, she ran three companies: DAIS, Intarka, and Uuma. Sramana has a master’s degree in electrical engineering and computer science from the Massachusetts Institute of Technology.

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