Case Study BenInsights – Large Employer
Discover how BenInsights® has empowered a large Fortune 500 employer to make data-driven decisions to reduce costs and meet their employees' healthcare needs.
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White Paper: Understanding Surgical Costs for Plan Sponsors
In this white paper, Claritev’s comprehensive surgical cost analysis provides insights to help understand and optimize healthcare expenditure through a data-driven approach.
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Managing GLP-1 Drug Expenses: Every Company’s Cost Profile is Unique
Struggling with managing rising GLP-1 drug costs? Every company's cost drivers are different, making a one-size-fits-all approach ineffective. Learn how data-driven insights can help employers balance coverage and costs while optimizing member outcomes.
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Case Study IOA
Claritev reduced Insurance Office of America's time spent on data acquisition and refinement with Claritev’s BenInsights™ by streamlining data integration and reporting.
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Rural Healthcare Hangs in the Balance, Price Transparency Data Can Help
Hospitals and health systems must move beyond merely complying with price transparency rulings. By shifting their attention to the insights within this data, organizations can develop strategies that will enable them to care for their communities in financially sustainable ways.
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Healthcare Price Transparency Data: A Tool for Informed Decision-Making or a Data Quality Pitfall?
To make it easier to work with publicly available healthcare price transparency data, many technology vendors have developed tools and platforms. Those solutions, however, are only as good as the underlying data.
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ESRD Premium Restoration Can Have a Large Impact Despite Small Number of ESRD Patients
ESRD premium restoration solutions help ensure Medicare Advantage plans are properly reimbursed for ESRD patients by identifying members with missing ESRD statuses and restoring the premiums. However, because of the low number of ESRD patients, small healthplans often underestimate the potential impact of using an ESRD premium restoration solution and decide against using one. This article explains why they should reconsider.
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Claritev and Law Enforcement Are On To These Healthcare Claim Schemes
As a part of Claritev’s Payment Integrity service, we review claims to ensure there are no billing errors and that the charges make sense. When we find mistakes or suspicious charges, we investigate. This blog details findings that left us shaking our heads.
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The Role of Artificial Intelligence in Payment Integrity
The future of healthcare payment integrity is here, and it’s powered by AI and machine learning. From detecting fraud to streamlining claims processing, these technologies are transforming how payors reduce costs and improve accuracy.
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Case Study- Managing the Rising Costs of GLP-1 Drugs
Rising use of GLP‑1 drugs like Ozempic is driving new cost pressures for employers. This case study shows how data‑driven insights can help plan sponsors identify inappropriate usage, take targeted action, and proactively manage trends to control pharmacy spend.