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Revenue Integrity

Translating data into potential action with
innovative and effective premium restoration solutions.

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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.

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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.

Learn More About MSP Validation

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.

Learn More About ESRD Premium Restoration

  • 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.

Engaging insights.

Claritev insights, resources, and case studies.

  • Strategic Guide: The Operational Value of Healthcare Pricing Intelligence

    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
  • illustration showing coin going into piggy bank

    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
  • Promotional image for a Claritev white paper titled Beyond Cost Containment. The white paper cover is displayed at an angle against a blue patterned background and includes a photo of two professionals reviewing documents. Large text at the bottom reads “WHITE PAPER.”

    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.

    Read More
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How can Claritev help create clarity and transparency in an effort to improve revenue integrity?

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

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