Case Study: Navigating a challenging environment

The Challenge

Property and casualty – Network-based

• Minimal provider noise through the use of network contracts to reduce medical cost
• Effective dispute resolution processing

The Solution

Claritev customized a process for the company to document success in resolving disputes:

• Custom reports to oversee its internal escalation process and compliance with turnaround time requirements
• Monitoring tool to gauge its staff’s compliance with internal processes and guidelines
• Proactive dispute resolution to alleviate carrier concerns, often more perception than reality

The Results

Claritev’s program enables superior carrier retention:

• Dispute rate less than 1% of bills processed
• Consistent achievement of contractual turnaround time obligations