Health plans want to ensure that all claims they pay are coded appropriately, but they often lack the internal resources to identify, quantify, and manage over-coding issues. As a result, incorrectly coded level 4 and 5 evaluation and management (E&M) claims can pass through their systems and be paid while physicians continue to over-code.

View our case study to learn how a Northeast health plan implemented Cotiviti’s E&M over-coding policy to identify and reduce physician over-coding with a defensible approach, saving $9.5 million in 2019 alone.