GOVERNMENT SOLUTIONS

Verify and validate.

From enrollment compliance to adherence with program requirements, we deliver verification and validation services to key stakeholders and regulators in their administration. Our professionally licensed investigative staff work with fraud SMEs and data analysts to provide accurate, reliable and actionable information to use in the fight against fraud. All the while continuing to provide oversight of benefits and entitlement programs. We empower program decisionmakers to make better payment decisions and ensure receipt of public services by those who are genuinely entitled to them. We also help confirm that providers who render and bill for services are authorized and perform those services according to program rules and regulations. As both an organization and a strategic partner with government vendors, we stand on the front line in the fight against fraud, waste and abuse.

HEALTH PLAN FWA SOLUTIONS

Powerfully effective.

CoventBridge Group’s industry leading expertise in revenue recovery and compliance, combined with our deep understanding of the need to maintain and improve provider relationships, enables us to successfully balance these competing priorities while delivering a valuable return to our health plan clients.

For over 20 years, the CoventBridge team has served as an FWA contractor for CMS investigating Medical Provider Fraud, Waste, & Abuse in Medicare, Medicaid, and commercial lines of business.

Strong roster of data analysts for prospective & retrospective reviews, Certified Coder Registered Nurses for clinical review and a national network of licensed investigators, along with in-house legal and clinical resources.

Experienced, flexible, and sensitive approach to preventing provider abrasion, while still achieving client objectives.