COTIVITI

Downloadable electronic publications, namely, downloadable e-books and downloadable informational brochures in the field of healthcare payment solutions

Healthcare cost containment, assessment, and analyses services; healthcare utilization and review services; medical cost management; collecting and analyzing claims data and quality metric data from healthcare organizations to ensure payment accuracy for health care purchasers, payors, and providers for business purposes; recovery audit services in the nature of reviewing medical claims billing systems to detect lost profits through overpayments in order to reduce health insurance costs related to claim payment errors for business purposes; medical records coding services for others in the nature of assignment of diagnostic and procedural codes for purposes of reimbursement from insurance to ensure payment accuracy; providing statistical evaluation of health insurance claims performance measures for others; payment management in the nature of providing chart review and clinical chart validation services in the nature of business data and management analysis services in the healthcare field for business purposes; healthcare claims management services, namely, receiving, data entering, and re-pricing of transactions that are originated by physicians, hospitals, and ancillary medical care providers to ensure payment accuracy; business intelligence assistance, advisory and consulting services in the field of healthcare network management; business consulting services for clinical and business process optimization; comparative business and industry statistical trend reporting and analysis services for business purposes; provision of marketing reports featuring information on retail transactions, promotions and pricing review information for products of others; business data analytics services; electronic data collection and data submission services for business purposes in the fields of medicine, healthcare, and retail; risk adjustment services, namely, financial record-keeping management and retrieval of abstraction in the nature of extracting and summarizing information from medical records for health insurance risk management and regulatory compliance purposes; business auditing support services pertaining to the Medicare Recovery Audit Contractor program and other federal healthcare programs, namely, the preparation, organization and presentation of the documents and data requested by a government body, and advice on government audit processes, policies and strategy; marketing consulting services, namely, customer engagement consulting services in the field of healthcare; customer outreach services, namely, marketing services for outreach to healthcare consumers; consumer strategy business monitoring and consulting services, namely, providing marketing advice regarding consumer relations management, consumer outreach and multi-channel communication campaign management, data management and analytics, behavioral assessment, and predictive modeling; providing reimbursement benchmarking information and other market intelligence to healthcare payors and providers; providing an online internet website portal featuring cost containment performance data in the areas of healthcare insurance claim fraud, waste and abuse for use by health care providers, administrators and health professionals; business intelligence services in the nature of continuous improvement processes for retailers; business consulting services in the field of contract management and compliance

Healthcare financial advisory services for providing payment integrity solutions; medical insurance case and utilization review and insurance claims adjustment services for healthcare purchasers and payers and providers and Medicare beneficiaries to ensure payment accuracy; medical insurance claims review services in the nature of assessing insurance claims to ensure payment accuracy; providing counseling and consulting in the field of healthcare insurance benefits; insurance claim administration consultation services; financial data analytics services; risk adjustment services in the nature of financial and insurance risk management consulting; providing financial payment accuracy information to healthcare consumers; financial auditing services to ensure payment accuracy; Insurance services, namely, providing information for the purpose of review and verification of Medicaid and Medicare eligibility status and related information

Education services, namely, providing non-downloadable webinars in the fields of healthcare, data analytics, payment accuracy, consumer engagement, and investigations related to fraud, waste, and abuse; providing a website featuring non-downloadable videos, non-downloadable blogs, non-downloadable articles, non-downloadable case studies, and non-downloadable white papers in the fields of healthcare, data analytics, payment accuracy, consumer engagement, and investigations related to fraud, waste, and abuse

Software as a service (SaaS) featuring software for assessment and management of healthcare practices, facilities, organizations, and provider networks; quality evaluation services of clinical and financial performance in the healthcare industry; quality control consultation services in the field of health care quality improvement pertaining to health care quality review and quality data analysis; data mining; providing on-line non-downloadable quality measure logic and reporting software for collecting, measuring, monitoring, evaluating, and reporting information in the field of healthcare cost containment and retail services; providing online non-downloadable software for monitoring, alerting prioritizing, and resolving payment accuracy issues; providing on-line, non-downloadable software for data analytics; computer services, namely, hosting an interactive web site for educating consumers that allows users to interpret and assess healthcare information and payment accuracy analytics; providing online non-downloadable software for commercial and government health payers and at-risk providers to conduct population health and risk analytics, predictive member health modeling, and conduct member engagement activities using an insured individual's health related data; providing online non-downloadable software for managing the subrogation of insurance claims and the coordination of benefits on behalf of state and federal healthcare programs; providing temporary use of non-downloadable cloud-based audit recovery software for monitoring and evaluating payment integrity issues; providing an Internet website portal featuring online, non-downloadable analytic software to identify and prevent healthcare insurance claim fraud, waste and abuse; providing online non-downloadable software to manage healthcare insurance member engagement and care, conduct population health and risk analytics, and improve health outcomes through data warehousing, analytics engines, predictive modeling, and machine learning; data automation and collection service using proprietary software to evaluate, analyze and collect healthcare payment data; providing on-line non-downloadable software using artificial intelligence for machine learning to provide payment integrity solutions; software as a service (SaaS) featuring software for offering data analytics to identify margin accuracy issues such as duplicate payments, price anomalies, missing promotional funds, and payment term errors related to goods-for-resale transactions; providing temporary use of non-downloadable cloud-based software for engagement with healthcare payers and consumers; providing an internet website portal featuring technology that enables users to engage directly with healthcare payers and consumers; Providing fraud and abuse support in the healthcare industry, namely, digital forensic investigations in the field of computer crimes related to healthcare fraud; Fraud detection services in the field of health care insurance, namely, computer security threat analysis for protecting healthcare data

Providing fraud and abuse support in the healthcare industry, namely, fraud and abuse surveillance and investigation services related to healthcare insurance claims and physical security of patients; Providing fraud and abuse support in the healthcare industry, namely, regulatory compliance auditing and consulting services and tracking and monitoring regulatory requirements in the field of healthcare fraud for regulatory compliance purposes; Providing fraud and abuse support in the healthcare industry, namely, monitoring of computer systems in the nature of surveillance services relating to the physical safety of persons and security of tangible property; Fraud detection services in the field of health care insurance, namely, analyzing data in computer databases for criminal activity related to healthcare fraud or identity theft; compiling and analyzing statistical health data in order to uncover and identify health care fraud and claims errors; investigative services related to insurance claims