All PlansAdministrativeMedium impact
Introducing Claim Pattern Review Program from Cotiviti
Healthfirst·Provider Update
We identified it
Jun 20, 2026
Summary
A new Claim Pattern Review Program from Cotiviti has been introduced to analyze provider claim submission patterns and identify potential issues or optimization opportunities. This program will monitor billing practices and may result in provider outreach or corrective action requests.
Action Required
Immediately: Review current claim submission patterns and ensure all billing practices comply with payer guidelines. Billing team should monitor for any communications from Cotiviti regarding claim patterns and respond promptly to any review requests or corrective action notices.