Pre-Payment Integrity

Combining automated technology and human intelligence to address clinical billing challenges.

Improving Accuracy

Expert Reviews

Identifying potential errors and helping clients address waste and abuse.

Pre-payment integrity doesn’t have to be complicated or costly. Claritev helps address everything from identifying simple coding errors to complex clinical billing issues, bringing greater transparency and confidence to the payment process.

By bringing together advanced analytics with hands-on clinical and coding expertise, we can identify issues that traditional edits may miss and potentially resolve them to help avoid waste or provider friction.

How Claritev creates a difference in pre-payment integrity:

We go beyond automation.

Clinical review is integrated into our pre-payment integrity solution.

We know pre-payment.

Claritev brings over 45 years of pre-pay experience.

We know how to identify waste & abuse.

With our long track record in the healthcare space, we have seen some of the most creative billing schemes.

We’re clinically focused.

We involve clinicians at every step, every day.

We know providers.

Our team works with 1.4 million practitioners and facilities.

We’re a trusted partner.

Over 300 payer clients depend on Claritev for pre-payment clarity.

Supporting pre-payment integrity  with data-driven solutions and expertise.

Advanced Code Editing

Advanced Code Editing (ACE) uses intelligent automation and expert clinical review to detect coding errors in both in-network and out-of-network claims.

Learn More About ACE

Clinical Negotiations

Clinical Negotiations involves identifying billing errors, consulting with clinicians, and engaging Claritev’s specially trained negotiators to work toward fair payment reductions. Providers ultimately sign off on reductions, which helps decrease balance billing of members.

Learn More About Clinical Negotiations

Itemized Bill Review

Our Itemized Bill Review (IBR) service helps you find high-dollar claims, review specific cases you choose, or use both methods together. We focus on complex billing issues such as duplicate charges or miscoded services and can recommend or negotiate appropriate reimbursement.

Learn More About IBR

This internship gave me the chance to jump into real work and contribute to projects that mattered. Throughout the summer, I learned a lot and always felt supported by my mentors and teammates whenever I had questions or wanted to take on something new. I was introduced to technologies and career paths I didn’t even know existed, and I had a lot of fun along the way!

Technology Leadership Program Intern

Richard

Engaging insights.

New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.

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