As No Surprises Act disputes continue to rise, health plans are looking for smarter ways to manage IDR volume and costs. Learn how payers are using data-driven strategies to identify ineligible claims earlier, improve negotiation decisions, and keep more claims out of the IDR process.
Discover a practical approach to improving financial performance while supporting community health needs. In this article for the National Rural Health Association (NRHA), Jigar Patel, M.D. shares a three-step framework to help healthcare leaders understand market dynamics, identify growth opportunities, and make data-driven decisions that strengthen sustainability and access to care.
Fernando Schwartz, PhD, Senior Vice President and Chief AI Officer at Claritev, outlines the five standards he uses to evaluate responsible AI and shares how organizations can empower their workforce with the right tools.
Discover how Claritev’s Chief AI Officer, Fernando Schwartz, is leveraging advanced AI to reduce healthcare’s administrative burden—streamlining claims processing, accelerating decisions, and cutting costs in an industry where bureaucracy accounts for 15–25% of total expenses.
Healthcare enters 2026 at a critical turning point. In this post, Claritev President & CEO Travis Dalton outlines four key priorities—from cost transparency to workforce sustainability and health equity—that can help the industry move forward with clarity, confidence, and purpose.
Healthcare is a major expenditure for employers and employees, yet Americans purchase it without insight into price or quality. Medical costs contribute to 66.5% of household bankruptcies—lack of transparency is a contributing factor. Employers, payors and providers should consider alternative models of care such as value-based plans with built-in access and transparency.
As we look forward to the new year, we will see payors, providers, and consumers collaborating to improve the healthcare experience. One thing is a sure bet, healthcare will remain a dynamic industry with creative solutions emerging throughout 2023 and beyond.
Ryan Day breaks down the current healthcare benefits landscape on the Payment Matters podcast with Jeff. Lin. Listen to learn how reference-based pricing as part of a value-driven health plan services gives employers the power to control rising employee healthcare costs.
Americans are concerned about rising healthcare costs, and among the insured, almost half worry about covering their deductible. With the cost of employee benefits projected to rise, employers and employees are looking for ways to lower costs. Ryan Day, President of HST, a Claritev Company, outlines ways reference-based pricing provides value, transparency, and quality in employee benefits.
MultiPlan’s Susan Mohler will present at the Texas Covered Health Care Conference, offering expert insights on navigating the No Surprises Act and helping payors adapt to evolving regulatory requirements.