Solution Area: Data & Analytics

  • Top view of woman sitting on the floor reviewing medical bills

    COVID-19 Crisis Creates Environment for Inaccurate Billing

    The COVID-19 crisis created rapid changes in healthcare delivery and billing practices, increasing the risk of inaccuracies and inefficiencies. As new treatment protocols, coding updates, and regulatory shifts emerged, healthcare payors faced heightened pressure to detect errors, maintain compliance, and ensure payment accuracy in an evolving environment.

  • Top view of people putting their hands together in circle formation

    These Three Attributes Help Healthcare Payors Manage Costs

    Healthcare payers face constant pressure to control costs in an increasingly complex and fast-moving environment. Success depends on three critical attributes: customization, flexibility, and speed to market. By tailoring solutions to unique organizational needs, remaining agile in response to change, and rapidly deploying effective strategies, payers can better manage costs while maintaining accuracy, efficiency, and member satisfaction. [claritev.com]

  • Looking over women's shoulder as she is signing into her laptop on a desk with plant behind computer

    Technology Tools That Simplify Work During a Complicated Time

    Technology has played a critical role in helping organizations maintain operations during challenging times. From enabling remote work for the majority of employees to supporting telemedicine growth and enhancing provider communication through digital portals, these tools have simplified complex workflows, improved access to care, and ensured business continuity in a rapidly changing healthcare environment.

  • Pink and blue background with wooden building blocks set upon background in a stepped up formation, hand adding final block

    Building Blocks to Help Healthcare Payors Thrive in Our New Normal

    Healthcare payors are navigating uncertainty in the “new normal,” facing challenges like shifting claim volumes, cost pressures, and limited resources. By leveraging flexible, customizable building blocks—such as network-based, analytics-driven, and payment integrity solutions—organizations can adapt to change, maintain financial control, and strike a balance between cost savings, provider relationships, and member satisfaction. [claritev.com]

  • Business man touching a screen with the words "machine learning" displayed

    Machine Learning Drives Efficiencies at Claritev

    Machine learning is helping drive efficiency and accuracy across healthcare operations by enabling systems to learn from data and automate complex processes. At Claritev, this technology is used to prioritize claim reviews and enhance payment integrity, allowing teams to focus on high-value tasks, reduce manual effort, and scale operations while delivering greater value to clients.

  • Female and two males looking at paper and laptop

    Case Study: Retaining important business

    Claritev analysis helped a third-party administrator defend against a competitor’s push to implement Medicare pricing by: significantly improving savings for the employer and its members; engaging important providers in the new process; and preserving the community’s provider-patient relationships.

  • Two males and two females at conference table with laptop and coffee

    Case Study: Navigating a challenging environment

    An auto medical services provider wanted to distinguish its network-based cost management program to sensitive auto insurance carriers by demonstrating: minimal provider noise through the use of network contracts to reduce medical cost; effective dispute resolution processing.