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

Industry Leader Recognition

Claritev has been recognized as a Leader in the Everest Group Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026, highlighting the company’s leadership in connected payment integrity, responsible AI, and technology-enabled solutions that improve payment accuracy.

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Why Pre-payment Integrity Matters More Than Ever

Chief Operating Officer, Jerry Hogge, explores why payment integrity is critical to reducing costs, improving accuracy, and strengthening payer-provider relationships as healthcare claims grow more complex.

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Our payment and revenue integrity solutions fall into three distinct categories that cover the entire claims lifecycle.

Pre-Payment Integrity

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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

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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

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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:

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
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
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.

National Health Plan

Engaging insights.

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

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…
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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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