Innovations in Payment Integrity: Stopping the Spread of Waste and Abuse Related to Infectious Disease

Detecting Waste and Abuse


Having detected over $22 million in waste and abuse for our clients, Claritev takes a proactive approach to waste and abuse detection. By analyzing infectious disease billing trends, such as RSV and COVID-19, Claritev can help clients detect and prevent overpayments. 

  • Analyze claims early upon receipt
  • Implement innovative approaches to claim editing
  • Develop new algorithms for error detection
  • Analyze facilities and other demographically associated claim types

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

  • Medicare Advantage Expansion Strategy

    Explore a practical framework for evaluating Medicare Advantage expansion opportunities, assessing network feasibility, and making more informed go/no-go decisions.

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  • Rethinking Reference-Based Pricing

    Reference-based pricing is evolving to meet the demands of rising healthcare costs, shifting market conditions and changing business priorities. This white paper explores how…

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  • Beyond Cost Containment

    Learn how TPAs can improve affordability, scale efficiently, and make better decisions with connected infrastructure that drives growth, efficiency, and long-term profitability.

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