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

Learn More

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

Learn More

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

Learn More

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

Learn More

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.

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
You have been a great partner from day one. You collaborate with us until we find a resolution. We look forward to a long-standing partnership.

Payment Integrity and Performance Manager
The things we value most about our partnership with Claritev are not just the reliable, efficient delivery of savings through their MSP and ESRD services, but the fact that they are always willing to come to the table to discuss and collaborate on new and innovative solutions that nobody else in the industry has yet to try.

Drew Satriano, VP of Payment Integrity

Highmark, Inc.
In our experience, Claritev has been very responsive with great turnaround times and the findings they’ve presented to SIHO have been accurate and reasonable.

Claims Department

SIHO Insurance Services, Inc.

Engaging insights.

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

Webinar Recording: Final Rule – Navigating NSA Independent Dispute Resolution Operations

CMS’s latest IDR Operations Final Rule brings important changes to the No Surprises Act dispute process. This webinar highlights key updates, workflow impacts, and…
Read More
A Single-Vendor Approach May Improve Your Payment Integrity Program

A Single-Vendor Approach May Improve Your Payment Integrity Program Brad Ross Senior Vice President, General Manager Payment & Revenue Integrity, Claritev In 2024, spending…
Read More
Q&A with Kinetiq Health’s Chief Clinical Officer

Sarah Michaels, Chief Clinical Officer of Kinetiq Health, makes the opportunity clear: healthcare can use data to make decisions that lead to better outcomes…
Read More