Revenue Integrity

Revenue Protection

Data-Driven Approach

End-to-end revenue integrity solutions, powered by data and amplified through experience.

When premiums don’t align with membership data, the path to revenue can become opaque. Claritev’s Revenue Integrity solutions bring clarity to this complexity for Medicare Advantage plans. Our solution can work to recover premium dollars already earned while helping to prevent future underpayments.

We take a partnership-oriented approach to improving revenue integrity, prioritizing transparency as our team works to identify issues, coordinate updates, and reconcile adjustments.

With deep experience navigating CMS processes and a focus on bringing insight to light, we can help restore revenue, reduce friction, and bring confidence back to premium payments.

What’s new in revenue integrity:

Potentially Restoring millions for your Medicare Advantage plan

Correctly paid Medicare Advantage premiums are a critical source of revenue for many health plans. Incorrectly paid premiums can result in millions of dollars in lost revenue. Download our eBook to find out how you can take charge of your premium revenue.

Supporting revenue integrity with data-driven solutions and expertise.

Medicare Secondary Payer Validation

Claritev’s MSP Validation solution helps Medicare Advantage plans quickly correct MSP inaccuracies, resolve primacy errors, and recover millions in underpaid premiums using secure, CMS-ready technology and expert support.

End-Stage Renal Disease Premium Restoration

Our ESRD Premium Restoration solution helps Medicare Advantage plans identify members with missing or inaccurate ESRD status, validate documentation, and recover underpaid premiums through advanced analytics, CMS collaboration, and a transparent, results-driven approach.

  • 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.

Claritev insights, resources, and case studies.

  • How Carlinville Hospital Improved Financial Performance Through Denial Visibility, Revenue Cycle Prioritization, and Operational Alignment

    See how Carlinville Area Hospital improved denial visibility, strengthened revenue cycle priorities, and aligned financial and operational goals to drive better performance.

    Read More
  • Tried and True, but Better: Building a Modern Network Strategy

    Tried and True, but Better: Building a Modern Network Strategy David Murtagh discusses how flexible, data-driven network strategies can help self-funded plans deliver greater…

    Read More
  • Medicare Advantage Expansion Strategy

    Explore a practical framework for evaluating Medicare Advantage expansion opportunities, assessing network feasibility, and making more informed go/no-go decisions.

    Read More
Pattern

Learn how Claritev can help maximize recoveries and prevent overpayments with data-driven solutions.