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Data Mining

Uncovering opportunities to help reduce billing and contract payment errors hidden within your data.

Contact Claritev

Overpayment Detection

Maximizing Recoveries

Digging deeper into the data to help recover and reduce over payment errors.

Claritev’s Data Mining solution helps uncover and recover overpaid claims through the use of industry-leading analytics and experienced human review.

We can identify payment issues linked to billing errors, adjudication gaps, and contract language, then potentially turn those insights into immediate recoveries and use them to inform long-term, cost-prevention strategies.

How is Claritev’s data mining solution different?

Uses over advanced technology to identify improper payments on medical and pharmacy claims.

Gives plans the information needed to update their editing systems and potentially prevent future overpayments.

Works on its own or as a complement to existing processes.

Combines flexible, sophisticated analytics and logic with human intelligence to help catch and prevent overpayments.

Provides detailed overpayment concept information in a white paper, outlining reasons, sources, and claim examples for easy client approval.

How our Data Mining solution works.

Go deep into your data to potentially uncover and recover overpayments previously
missed by current processes, with the ability to identify and explain issues.

This intelligence and automation helps reduce your administrative expenses and overall per-member spend.

Investigate

01 Investigate

  1. Review Concept Leads and Policies
Analyze

02 Analyze

  1. Run Data
  2. Validate Concept
  3. Write Concept White Paper
Approve

03 Approve and Track

  1. Send for Client Approval
  2. Adjust, Collect, and Record Savings

Engaging insights.

New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.

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How can Claritev support your data transformation to reduce billing and payment errors?

Learn how Claritev can help maximize recoveries and prevent overpayments with data-driven solutions.

Contact Sales