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Revenue Integrity

Translating data into potential action with
innovative and effective premium restoration solutions.

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Revenue Protection

Data-Driven Approach

End-to-end revenue integrity solutions, powered by data and amplified through experience.

When premiums don’t align with membership data, the path to revenue can become opaque. Claritev’s Revenue Integrity solutions bring clarity to this complexity for Medicare Advantage plans. Our solution can work to recover premium dollars already earned while helping to prevent future underpayments.

We take a partnership-oriented approach to improving revenue integrity, prioritizing transparency as our team works to identify issues, coordinate updates, and reconcile adjustments.

With deep experience navigating CMS processes and a focus on bringing insight to light, we can help restore revenue, reduce friction, and bring confidence back to premium payments.

What’s new in revenue integrity:

Potentially Restoring millions for your Medicare Advantage plan

Correctly paid Medicare Advantage premiums are a critical source of revenue for many health plans. Incorrectly paid premiums can result in millions of dollars in lost revenue. Download our eBook to find out how you can take charge of your premium revenue.

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Supporting revenue integrity with data-driven solutions and expertise.

Medicare Secondary Payer Validation

Claritev’s MSP Validation solution helps Medicare Advantage plans quickly correct MSP inaccuracies, resolve primacy errors, and recover millions in underpaid premiums using secure, CMS-ready technology and expert support.

Learn More About MSP Validation

End-Stage Renal Disease Premium Restoration

Our ESRD Premium Restoration solution helps Medicare Advantage plans identify members with missing or inaccurate ESRD status, validate documentation, and recover underpaid premiums through advanced analytics, CMS collaboration, and a transparent, results-driven approach.

Learn More About ESRD Premium Restoration

  • The things we value most about our partnership with Claritev are not just the reliable, efficient delivery of savings through their MSP and ESRD services, but the fact that they are always willing to come to the table to discuss and collaborate on new and innovative solutions that nobody else in the industry has yet to try.

    Drew Satriano, VP of Payment Integrity

    Highmark, Inc.

Engaging insights.

Claritev insights, resources, and case studies.

  • Illustration showing a computer monitor with two gear icons on the screen and an arrow pointing toward a hand holding a star, symbolizing transforming processes or capabilities into successful outcomes. The image has a blue background and the word “ARTICLE” appears at the bottom.

    Future-State Success Depends on Present-State Stability

    During an EHR transition, the biggest risk often isn’t the future-state platform—it’s the current-state environment that continues to power patient care, clinical workflows, revenue…

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  • Discover the latest IDR trends, provider win rates, and strategies to help payers reduce risk and improve reimbursement decisions.

    The State of IDR in 2025: Trends, Market Dynamics, and Strategic Insights for Payers

    WHITE PAPER The State of IDR in 2025: Trends, Market Dynamics, and Strategic Insights for Payers Navigating rising dispute volume, provider-favored outcomes, and growing…

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  • Cover image for a Claritev white paper from Everest Group featuring a close-up of metallic chain links that appear to be breaking apart into crystalline fragments against a blue sky background. The Claritev logo and the text “An Everest Group report” appear in the upper-right corner, with “WHITE PAPER” displayed prominently at the bottom.

    The Next Evolution of Payment Integrity

    Move beyond recovering payment errors after they happen. This white paper explores how connected payment integrity, powered by responsible AI and advanced analytics, helps…

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How can Claritev help create clarity and transparency in an effort to improve revenue integrity?

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

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