Payment & Revenue Integrity Solutions
Intelligent solutions that help drive payment accuracy and savings across the entire claims lifecycle.
Payment Accuracy
Cost Containment
We aim to bring clarity and efficiency to eligibility and claims analysis, so they are processed correctly the first time.
Given the challenges healthcare organizations are up against, the ability to quickly and successfully identify errors in healthcare claims has never been more important.
Our approach to payment and revenue integrity is not as a vendor, but as a partner. With services and solutions that span the claims lifecycle and fully customizable solutions to meet your specific needs, we aim to provide long-term transparency that helps reduce waste and drive meaningful savings. We don’t employ one-size-fits-all strategies, and we proactively strive to minimize provider abrasion, aiming for low appeal rates.
$1.8B
Medical cost savings in Payment Integrity in 2025
80M+
Code Combinations
Our payment and revenue integrity solutions fall into three distinct categories that cover the entire claims lifecycle.
Pre-Payment Integrity
Whether the claim is for a low-dollar doctor’s visit, a costly hospital stay, or something in between, Claritev has a pre-payment integrity solution to identify potential errors.
Pre-payment solutions include:
Post-Payment Integrity
Claritev’s post-payment integrity services aim to maximize recoveries from other responsible parties and help prevent future overpayments.
Post-payment solutions include:
Revenue Integrity
Find and restore premium dollars owed to you for managing Medicare Advantage members. We help to manage disease statuses and ensure you receive accurate premium payments from the Centers for Medicare and Medicaid Services.
Pre-payment solutions include:
Engaging insights.
New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.
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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…
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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…
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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…
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Seeking clarity to inform your complex decisions?
Reach out to Claritev to learn how our solutions aim to go beyond improving affordability and increasing transparency to enabling affordable care for all.