Solutions

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

Claims Intelligence Solutions

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

Data & Analytics Solutions

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

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.


Revenue Integrity

Payment & Revenue Integrity Solutions

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.

  • In a remote community like ours, we do not have local access to every type of medical specialist. The MAVEN Project gives our providers a trusted resource when a patient’s care would benefit from specialist input and helps us make better-informed decisions about whether someone truly needs to travel off island. This grant means we can continue that support for another year.

    Chief Executive Officer, Kodiak Community Health Center

    Olivera Wilson

  • When someone comes through our doors with a serious or uncertain condition, every minute matters. Having portable ultrasound available at the bedside will give our clinicians another important tool to understand what is happening and make decisions faster. We are incredibly grateful to Claritev Cares and to our community for helping us get this across the finish line.

    Chief Executive Officer, Fairfield Memorial Hospital

    Andy Flemer

  • Rural healthcare organizations know exactly what would make a difference for their patients. The challenge is often finding the resources to make it happen. These grants help close that gap. One will put important diagnostic technology directly at the bedside, and the other will help patients benefit from specialist expertise without automatically having to leave their island community.

    Executive Director, Claritev Cares

    Andrew Loudner

  • Accurate payments help reduce unnecessary administrative costs, support stronger payer-provider relationships, and contribute to a healthcare system that promotes affordability and predictability for the people who depend on it every day.

    Chief Operating Officer, Claritev

    Jerry Hogge

  • Claritev’s broad pre-pay value chain coverage and clinical negotiation experience give it a foundation to support payers on upstream payment accuracy needs.

    Vice President, Everest Group

    Ankur Verma

  • 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

Engaging insights.

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

  • The Fountain of Youth in Healthcare is Fostering an Innovation Mindset

    What keeps a 45-year-old healthcare company innovative in a rapidly changing market? Learn how strategic investment, operational agility, and actionable insights help organizations navigate…

    Read More
  • Strategic Guide: The Operational Value of Healthcare Pricing Intelligence

    Healthcare transparency data offers significant potential, but turning it into actionable insights requires the right strategy. Learn how healthcare pricing intelligence helps organizations improve…

    Read More
  • 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…

    Read More

Reach out to Claritev to learn how our solutions go beyond reducing costs and increasing transparency to enabling affordable care for all.