Solutions

Reduce costs, improve access, and illuminate insight across the healthcare ecosystem.

Cost Optimization

Data-Driven Insight

Bringing Clarity to Data Chaos

The complexities of the healthcare industry, combined with vast amounts of data, make it difficult to clearly see opportunities for improvement and to make the best decisions.

Claritev applies AI-driven analytics and decades of experience to make cost, pricing, and payment dynamics easier to understand and navigate.

When decisions are grounded in clear, objective insight, the healthcare system works better – leading to greater affordability, fewer surprises, and better outcomes for patients.

Transforming healthcare data into
actionable insights and outcomes.

Claims Intelligence Solutions

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Escalating costs and surprise bills put pressure on both plans and members. Our Claims Intelligence Solutions clarify the complex with expert negotiation, reference-based pricing solutions, and surprise-bill services that help reduce spend and safeguard the member experience.

Data & Analytics Solutions

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Waste and inaccurate payments can drive up health expenditures. We work to bring clarity to the process by promoting accuracy, recovering revenue, and strengthening provider relationships – helping reduce waste and abuse across the healthcare ecosystem.

Network Solutions

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With rigorous credentialing and over 1.4 million participating providers, we aim to expand nationwide access to high-value care and lower out-of-pocket costs for patients. At the same time, we aim to help providers strengthen cash flow and extend their reach across a diverse base of payers.

Payment & Revenue Integrity Solutions

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Increased waste and inaccurate payments continue to drive up health expenditures. We bring clarity to the process by ensuring accuracy, recovering revenue, and strengthening provider relationships – helping to reduce waste and abuse across the healthcare ecosystem.

The grant money we received from Claritev was used to support additional resources that allow our respiratory therapists to spend more time empowering and educating patients.

Lisa Emery

Director, New River Health Association Breathing Center
These resources were created to help military and veteran caregivers more easily understand options for meaningful mental health care for themselves and their families. Caregivers shoulder extraordinary responsibilities every day, and they deserve clear, trusted guidance that helps them navigate complex healthcare systems with greater confidence.

Steve Schwab

Chief Executive Officer, Elizabeth Dole Foundation
This collaboration (with the Elizabeth Dole Foundation) reflects a shared commitment to helping military and veteran caregivers navigate mental healthcare more clearly and confidently. These families have given so much in service to our country, and they deserve resources that are practical, accessible, and grounded in empathy.

Carol Nutter

Board Chair of Claritev Cares & Chief People Officer, Claritev
Your team is great at building trust. I have had nothing but a positive and efficient experience.

Manager

Large Midwest health plan
These are really important things that we wouldn’t be able to do without a partner like Claritev because, again, we want to look at this stuff holistically across carriers. It would take me four times as long to go into every health plan and do this kind of analysis.

Executive Vice President

Large, regional consulting firm/insurance brokerage
They (Claritev) are continuously refining and developing the platform to meet my needs.

A Major Healthcare Provider
The Technology Leadership Program has brought my department tremendous value. The well-structured program offers the talented hardworking associates options for their career paths, yet exposes them to high visibility initiatives. Every associate has brought a unique perspective and strong professional skills to the organization.

Bobby Vincent

Senior Information Technology Director
The Technology Leadership Program associates have a tremendous opportunity before them. To have three years to rotate through various departments within Information Technology before deciding which role/area suits them best.  Depending on their choice and interest, they become a unique blend of technologist, business expert and, eventually, corporate leader.

Andrew George

Senior Vice President, Information Technology
One of the great successes of the program has been our ability to identify and develop emerging leaders whom contribute in every facet of our business. It hasn’t been just about growing IT leaders, it’s about maturing business leaders for Claritev.

Ed Ververs

Senior Director, Telecom & Data Center Management
I had the privilege to mentor some of the Technology Leadership Program participants and was fortunate to absorb a member into my team, where he has helped tremendously with new automation techniques. Participants bring in fresh perspectives and extreme enthusiasm to IT here at Claritev. I’m looking forward to adding more.

Vasu Raghunathan

Senior Director of Data & Service Delivery

Engaging insights.

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

Rethinking Payment Integrity: Why Prevention Is a Strategic Advantage

Stopping overpayments before they occur can generate significantly greater value than recovering them after the fact. Explore the advantages of pre-pay payment integrity programs…
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Beyond Cost Containment

Learn how TPAs can improve affordability, scale efficiently, and make better decisions with connected infrastructure that drives growth, efficiency, and long-term profitability.
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It’s Time to Take Avoidable Costs Out of Healthcare

For too long, healthcare has treated cost as a problem to solve after care is delivered. The future of affordability depends on understanding costs…
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