Identifying Anomalies in Claims Data Leads to More Savings for Healthcare Payors
Claritev discusses a data science initiative that identifies anomalies in the data and is helping to improve its Payment Integrity service.
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Collaboration is No Longer Optional for Healthcare Players
Healthcare costs in the U.S. are rising to $4 trillion annually, accounting for 17% of the economy. The increased pace towards a value-based care system could be a crucial step to rein in the rising cost of healthcare. This trend accelerates the need for collaboration between payors, providers, employers and health plan members.
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What Is Subrogation?
Subrogation? What is it and what does it have to do with healthcare insurance? Subrogation, in layman’s terms, means a health plan can be reimbursed by the party whose insured was deemed responsible for an accident or injury.
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What Is Payment Integrity?
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.
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Five Healthcare Trends to Watch in 2022 that Can Rein In Skyrocketing Costs
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.
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The value of machine learning in the ESRD Premium Restoration process
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.
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New technologies drive Premium Restoration innovation
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.
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Premium restoration in an era of Medicare Advantage growth
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.
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Success with MSP and ESRD Premium Restoration
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.
