Case Study: Partnering to achieve certification

The Challenge

Property and casualty – Network-based

A workers’ comp services provider needed help maintaining State Certified Managed Care programs by:

• Eliminating provider coverage gaps in geographies not addressed by its proprietary network
• Strengthening coverage for key medical specialties

The Solution

Claritev customized a process to meet network access and mandated reporting requirements:

• MultiPlan Workers’ Compensation Network – adds access to 2,200 additional hospitals and over half a million other providers
• Customized reporting to assist in maintaining state-specific provider demographic data

The Results

Claritev helped the company maintain certification in three markets, together with:

• Over $100 million in charges covered annually under the expanded network arrangements
• Nearly $3 million in annual savings – an additional 7% below bill review reductions