Cotiviti Launches Enhanced Dental Claim Accuracy Solution for Payers
By Dr. Andrea Joy Smith
Video Credit: Cotiviti
Cotiviti has launched an enhanced dental claims review solution designed to help health and dental plans identify payment errors before claims are paid.
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SALT LAKE CITY, Aug. 5, 2026, (DrAndreaJoySmith.com) — Healthcare technology company Cotiviti has launched an enhanced version of its Dental Claim Accuracy solution for health insurance plans and standalone dental payers.
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The solution reviews dental claims before payment and supports both batch and real-time processing. It is integrated with Cotiviti’s Payment Policy Management platform, allowing clients to manage dental and medical claims through the same system.
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Dental Claim Accuracy uses configurable claim-editing rules, clinical validation by licensed dentists, analytics and documentation review to identify potential billing errors and suspected fraud, waste and abuse.
The updated solution also includes AI-assisted rule authoring intended to support policy development as billing practices and coding requirements change.
“With dental spending reaching an estimated $198 billion per year, dental payers face increasing challenges from fraud, waste, and abuse, overtreatment, miscoding, inappropriate billing practices, and rising coding complexity. These issues contribute to improper payments, increased administrative burden, unnecessary utilization, and pressure on plan resources. Dental Claim Accuracy brings the same proven platform, policy management capabilities, and transparency that payers rely on for medical claims into the dental space. By integrating dental claims onto our Payment Policy Management platform, both health and dental-only plans can simplify operations and strengthen payment accuracy as claim volumes grow,” said Matthew Hawley, Executive Vice President of Payment Integrity at Cotiviti.
The solution connects with Cotiviti’s Payment Clarity platform, which provides explanations of why claims were flagged, identifies the policies applied and outlines recommended next steps. It also provides reporting and analytics to help clients monitor claim activity, savings and program performance.
“Dental plans need solutions that can keep pace with evolving billing practices, increasing claim complexity, and emerging fraud, waste, and abuse patterns. By combining advanced claim editing with professional clinical validation, documentation review, and decades of dental expertise, Dental Claim Accuracy helps plans identify suspect claims before payment, improve the precision of payment decisions, and better protect both plan resources and member benefits,” said Canfield.
Cotiviti provides healthcare technology and data analytics solutions focused on claims processing, payment accuracy, operational efficiency and healthcare quality.
For more information, visit www.cotiviti.com.
Source: Cotiviti
