Health Plans
Bringing enterprise financial control into focus through integrated cost optimization and intelligence solutions.
Precision and clarity matter at every stage of the plan lifecycle.
Health plans operate in a market defined by rising medical costs, increasing transparency mandates, evolving CMS oversight, and mounting pressure to differentiate. Payment errors erode margins. Network gaps weaken competitiveness. Fragmented data slows decision-making.
Claritev helps bring these moving parts into alignment with a comprehensive portfolio of solutions that aim to empower health plans to move beyond siloed cost-containment efforts and toward enterprise alignment with greater financial control.
Together, these solutions can help:
• Improve predictability of medical spend and reimbursement exposure
• Optimize network performance and reimbursement alignment
• Validate and benchmark pricing strategy with reliable marketing intelligence
• Reduce volatility from out-of-network exposure
• Translate complex data into confident financial decisions
When every dollar and every provider relationship counts, clarity becomes one of the most important operational advantages.

Featured Solutions
End-to-end innovations designed to support health plan performance.

Payment and Revenue
Integrity Solutions
Increased waste and inaccurate payments continue to drive up health expenditures. We aim to bring clarity to the process by driving accuracy before, during, and after a claim, helping to reduce waste and abuse across the healthcare ecosystem.

Network Solutions
Network strategy is foundational for sustainable financial performance. We help health plans
gain greater flexibility and control over reimbursement and access, enabling more confident medical spend management and cost control.

Claims Intelligence Solutions
Escalating costs and surprise bills put pressure on both plans and members. Our Claims Intelligence Solutions aim to clarify the complexity with expert negotiation, reference-based pricing solutions, and surprise billing solutions that help support fair reimbursement for healthcare services and preserve member access and experience.

Data and Analytics Solutions
Health plans need clarity and confidence in
their data. When pricing and cost dynamics are clear, health plans can act decisively, govern their operations more strategically, and manage trends with greater predictability to drive smarter strategies and long-term performance.
Expert perspective
Q&A Kinetiq Health’s Chief Clinical Officer
Sarah Michaels, Chief Clinical Officer of Kinetiq Health, makes the opportunity clear: healthcare can use data to make decisions that lead to better outcomes for everyone.
Engaging insights.
Claritev insights, resources, and case
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Strategic Guide: The Operational Value of Healthcare Pricing Intelligence
Healthcare transparency data offers significant potential, but turning it into actionable insights requires the right strategy. Learn how healthcare pricing intelligence helps organizations improve…
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Rethinking Payment Integrity: Why Prevention Is a Strategic Advantage
Stopping overpayments before they occur can generate significantly greater value than recovering them after the fact. Explore the advantages of pre-pay payment integrity programs…
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The Connection Between Better Decision-Making and Healthcare Affordability
Healthcare affordability and access are often viewed as competing priorities—but they don’t have to be. By leveraging data-driven insights, network strategy, and greater price…
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Ready to move from fragmented cost containment efforts to integrated financial control?
Connect with Claritev to explore how our solutions can help strengthen network performance, validate pricing strategy, and govern their operations and financial outcomes with confidence.