- No public price.
- Not disclosed
- Not disclosed
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Population health
Cotiviti
by Cotiviti
Payer-side analytics: risk adjustment, payment integrity, and quality and Stars.
On this page
11/100Tracked
- Regulatory & Compliance0/22
No FDA clearance listed
- Clinical Integration0/31.8
No EHR integrations listed
- Evidence Strength0/20
No peer-reviewed coverage
- Vendor & Market9/24
Early-stage company
- Sentiment & Transparency3/15
Pricing on request, no public amounts
▸ Show all 11 dimensions▾ Hide dimension detail
- FDA clearance0/12
No FDA clearance listed
- HIPAA / SOC2 / BAA0/10
No public HIPAA/SOC2/BAA attestation
- EHR integrations (count)0/18
No EHR integrations listed
- Top-3 EHR coverage (Epic / Oracle / Athena)0/10
None of the top-3 EHRs covered
- Bidirectional write-back0/4
No bidirectional write-back documented
- Peer-reviewed papers0/14
No peer-reviewed coverage
- RCT / meta-analysis / systematic review0/6
No RCT, meta-analysis, or systematic review
- Funding & adoption signal9/18
Early-stage company
- Years in market0/6
Founded year not recorded
- Clinician sentiment (Reddit)0/9
No clinician sentiment data available
- Pricing transparency3/6
Pricing on request, no public amounts
Payer-side analytics: risk adjustment, payment integrity, and quality and Stars.
No public price.
Bottom line
Cotiviti is a payer-side analytics company. Health plans buy it for risk adjustment, payment integrity and quality reporting, and government programmes and provider organisations are secondary customers. A clinician does not select or run it. Its payment integrity work includes clinical chart validation and medical record retrieval, which is where a practice is likely to encounter it. Plans use it to audit claims and report HEDIS measures.
What is Cotiviti and who owns it?
Cotiviti says it "connects data, workflows, and intelligence across the healthcare ecosystem" and that it "enables healthcare organizations to deliver better care at lower cost". It claims to work with more than 200 payers and health systems, including all of the top 25 US plans. KKR and Veritas Capital each own half after a recapitalisation closed on 2 May 2024, which Nasdaq's press release describes. A media report put the valuation near USD 11 billion when talks became public in February 2024.
Veritas-backed Verscend agreed to buy Cotiviti on 19 June 2018 for USD 4.9 billion, according to Cotiviti's own release, and later took the Cotiviti name. Fierce Healthcare quoted USD 4.16 billion for the same deal. Third-party databases place the headquarters in Atlanta (Crunchbase) and South Jordan, Utah (PitchBook), and Cotiviti's own pages do not state one. The company sells enterprise contracts to plans and publishes no price.
What does it sell?
The solution pages describe a payer workflow:
- Risk adjustment, covering retrospective and prospective review, medical record retrieval and coding, suspect analytics and encounter management.
- Payment integrity, covering claim accuracy, coding validation, clinical chart validation, contract compliance, coordination of benefits and fraud, waste and abuse review.
- Quality and Stars, Quality Intelligence, Medical Record Abstraction, engagement, interoperability and itemised bill review, plus a retail line.
Cotiviti's associations page states NCQA HEDIS Certified Measures for its Quality Engine, held for "25 consecutive years". The homepage describes integration across "financial, administrative, and clinical workflows" without naming EHRs.
Which certifications does it list?
Cotiviti lists HITRUST CSF certification for its core healthcare solutions, URAC accreditation for Dental Claim Accuracy and the NCQA certification above, which covers HEDIS measures in the Quality Engine.
The verdict
Cotiviti is a payer-side vendor owned equally by KKR and Veritas Capital, with HITRUST, URAC and NCQA credentials listed on its associations page and an enterprise contract model for plans. By its own count it works with more than 200 payers and health systems.
Editorial review last generated October 15, 2026. Synthesized from clinician sentiment, peer-reviewed coverage, and our editorial silo picks. Refined by hand where vendor facts change.
What it costs
All tiers are custom-quoted. The vendor does not publish per-provider list pricing.
| Tier | Monthly | Annual | Notes |
|---|---|---|---|
| Enterprise | — | — | No public price. |
Source: vendor pricing page. Last checked October 15, 2026.
What deploys cleanly
Carries HITRUST CSF (core healthcare solutions and services), URAC accreditation (Dental Claim Accuracy), NCQA HEDIS Certified Measures (Quality Engine) per vendor documentation. Independent attestation review is the buyer's responsibility before clinical deployment.
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