COTIVITI

Recovery auditing software; computer software for tracking claims of vendor overpayments; data mining software; data analytics software

printed materials, namely, brochures, books, newsletters, magazines, reports, newspapers, manuals, pamphlets, journals and printed guides in the field of account auditing, business consulting, software, business support and analysis services

Account auditing services, namely, recovery audit services in the nature of reviewing accounts payable, purchasing systems, durable medical equipment payments, pharmacy claims and transactions, freight and vendor records, and medical claims billing systems to detect lost profits through overpayments, miscalculations, missed discounts, pricing errors, duplicate payments, incorrect invoices and missed credits, sales and use tax liabilities and payments, and contract and provider compliance; business consulting services, namely, providing procure-to-pay process improvement recommendations and providing industry benchmarks to gauge performance and guide policy decisions; business assistance, advisory and consulting services in the field of health care claims coding, billing patterns analysis, cost controls, payment policies, provider utilization patterns analysis, provider billing compliance review and analysis, integrated medical claims analysis, medical charts, product liability analysis, medication therapy management, and retro-termination claims review and analysis; providing business financial opportunity and cost analysis; network utilization analysis for healthcare business management; providing chart review services as part of business management in the healthcare field; consulting services in the cost and payment management of health care; medical claims management services, namely, receiving, data entering, and re-pricing of transactions that are originated by physicians, hospitals, and ancillary medical care providers; medical cost management; business assistance, advisory and consulting services in the field of healthcare network management; clinical and business process optimization services; business decision support, analytics and operations assessment services in the healthcare and retail fields; comparative business and industry trend reporting and analysis services; business management consulting services in the field of administration of payments for medical and clinical services; retail transactions, promotions and pricing review services; business and management consulting for healthcare providers, retail companies and related businesses; business data analytics services; statistical data analytics services; marketing data analytics services; business management consulting; business consulting; electronic data collection and data submission services for business purposes in the fields of medicine and healthcare; business information for enterprises; cost management for the healthcare benefit plans of others; insurance claims auditing services, namely, auditing healthcare claims submitted to insurers for instances of fraud and abuse by healthcare providers

Medical insurance case and utilization review and insurance claims adjustment services for healthcare purchasers and payers and providers and Medicare beneficiaries; medical insurance claims review services, including inpatient claims analysis, medical claims evaluation and management, network optimization and clinical and coding review services; healthcare benefit management and coordination services; providing healthcare benefit administration services; providing counseling and consulting in the field of healthcare benefits; insurance claim administration consultation services for payer owned PPOs to eliminate out-of-network claims

Electronic data interchange services in the field of healthcare transactions such as claims, eligibility, claim status, electronic remittance advice, prior authorizations, attachments and referrals that allow direct transaction and payment communications between healthcare providers and payers

Providing a website for use in recovery auditing featuring technology that enables users to store, track, analyze, communicate, and report on information from multiple recovery audit sources and audit efforts; IT consulting services; providing on-line, non-downloadable, Internet-based software application for medical billing for physicians and health care institutions; application service platform, namely, platform as a service (PAAS) featuring software for use in providing healthcare provider profiling; mobile application development; providing a website featuring technology that enables users to manage the vendor claim approval process; providing on-line, non-downloadable software for use in the data analytics field; computer services, namely, hosting an interactive web site that allows storing, tracking, analyzing, communicating and reporting on recovery audit activity and the results of analysis of accounts payable, purchasing system and medical claims billing transactions; application service provider featuring software for providing an online database in the field of transaction processing to upload transactional data, provide statistical analysis and produce notifications and reports; application service provider, namely, providing, hosting, managing, developing, researching, analyzing, reporting and maintaining applications, software and web sites for use by others in the fields of healthcare benefits programs, employee productivity and risk management; developing customized software in the field of recovery auditing for others; providing an interactive business customer accounting website featuring technology that allows business owners to retrieve customer data and audit customer accounts

Fraud detection services in the field of health care insurance