NYT Articles – Our Response

April 8, 2024

Claritev plays an incredibly vital role in the entire healthcare ecosystem – including providing value-add services to:

• 1.4 million contracted providers
• More than 100,000 employers and plan sponsors with 60 million plan members
• Over 700 healthcare payors

Each of these stakeholders relies on Claritev’s services and tools to avoid costly negotiations and ensure stronger and more efficient relationships between providers and payors, while ensuring market-based and fair pricing for healthcare services.

In fact, long before the passage of the No Surprises Act, Claritev has been committed to lowering out-of-network costs, reducing out-of-pocket expenses and removing balance bills from the healthcare system.

Some recent media coverage has missed the fundamental economics of the healthcare system, in particular, out-of-network healthcare services pricing, and resultant claims processing and adjudication and the sources of balance bills in the out-of-network realm. Claritev does not create balance bills; rather we seek to eliminate or minimize balance bills on behalf of our clients and their members. In fact, the number of claims where we eliminated balance bills (10M+) is more than was handled under the entire NSA regulatory framework in 2023.

• Claritev has provided network, negotiations, data analytics and other services for nearly 44 years that have improved price transparency, materially reduced or eliminated balance bills from providers given our widely accepted solutions and reduced the overall cost of care for all consumers of healthcare – payors, employers and patients.
• In 2023 alone Claritev identified over $22B in savings for payors, employers and consumers in the healthcare industry.

Claritev is and always has been focused on bending the cost curve in healthcare with fairness, efficiency, and affordability for consumers.