An estimated $1.2 trillion in healthcare spending is attributed to some form of waste or abuse that leads to overcharges. Payment integrity solutions are tools healthcare payors use to help bring down this staggering number. Claritev discusses what these solutions do.
While healthcare spending continues to soar, impacting all players in the healthcare ecosystem, Claritev understands it will take a combination of forces chipping away at the margins to make healthcare more affordable. Here are five trends we’re watching in 2022 with the potential to lower costs, improve outcomes, and make our health system more sustainable over time.
Claritev takes an innovative approach to ESRD premium restoration, combining machine learning and human intervention to help our clients identify and restore premium dollars for this costly care.
Innovations in AI and machine learning unlock opportunities to eliminate waste, reduce costs, and make healthcare more affordable. Claritev offers the best of both machine power and human power to help Medicare Adavantage plans ensure the accuracy of CMS premiums.
Expanding on one of the top payment integrity trends for 2021, this blog post focuses on growth in Medicare Advantage enrollment and the revenue integrity challenges it brings for health plans.
We explain the many revenue integrity challenges health plans face and walk through a variety of client examples illustrating the breadth of value obtained in premium restoration from our Medicare Secondary Payer Validation and End-Stage Renal Disease Premium Restoration solutions for our health plan clients with varying member sizes.
Members with End-Stage Renal Disease (ESRD) significantly impact your Medicare Advantage plan—learn how to navigate the complex process for recovering millions in underpaid premiums.
Ensuring accurate premium payments for your Medicare Advantage members requires the right people, processes, and technology. Find out which four steps you can take to capture underpaid Medicare Secondary Payer(MSP) & End-Stage Renal Disease (ESRD) premiums and ensure accurate premium payments going forward for your Medicare Advantage members.
Given the many changes in 2021, Medicare Advantage plans and their members will need to adjust. These changes are positive for members—for health plans, these changes can have a profound impact and will require the health plans to keep a close eye on cost-containment strategies.
