Health tech company Cotiviti is building out its payment accuracy platform for payers with two new additions that will allow plans to see all inpatient claims in one place.
The company said in an announcement that the enhanced platform reduces administrative complexity and unites elements that insurers typically managed through separate programs or vendors. Reducing those siloes can support more accurate claims management, Cotiviti said.
The first add-on is called Itemized Bill Review, which digs into high-cost facility claims to identify potential billing errors including miscoding, upcoding or duplicative charges. The Inpatient Coding Validation tool, meanwhile, supports a stronger diagnosis-related group review process that offers a fuller coding and clinical analysis before payments are made.
Cotiviti said that the tools taken together can identify between 9% and 12% in additional errors for submitted inpatient claims, alongside simplifying the process on the payer's end.
"Inpatient claims are among the most complex to review, and even small documentation or coding gaps can have a significant financial impact," said James Lee, M.D., senior medical director at Cotiviti, in the announcement. "These new capabilities give our clinical team a more complete picture of each claim, helping us catch errors more accurately and ensure payments reflect the care that was actually provided."
The company said that the expansion builds on the foundation of its existing payment accuracy tools to help plans see potential issues sooner and avoid significant pitfalls in the process before payments are made.
Cotiviti's clients provide health coverage and care to more than 300 million insurance members and patients, the company said.