A health plan facing tight deadlines needed rapid access to providers to meet network adequacy requirements. By leveraging existing contracted providers and targeted credentialing strategies, Claritev enabled faster network expansion—helping the plan meet compliance requirements, accelerate market entry, and maintain flexibility for future growth.
Claritev analysis uncovered opportunities for a third-party administrator using a variety of PPO networks to: improve payment accuracy – too much was being missed in the existing editing process; gain control over clinical billing waste and abuse; and minimize provider abrasion to preserve leased network relationships.
Congratulations to the 2019 MultiPlan Rural Health Grant recipients. Learn more about this year's award and how each recipient is putting their grant to great use in their community.
MultiPlan awarded $36,000 in rural health grants to four hospitals, supporting innovative programs designed to improve access to care and address critical healthcare needs in underserved communities.
A workers’ comp services provider needed help maintaining State Certified Managed Care programs by: eliminating provider coverage gaps in geographies not addressed by its proprietary network; strengthening coverage for key medical specialties.
MultiPlan appointed Karen Eaton as Vice President of Sales and Account Management for its Government segment, leveraging her extensive experience to drive growth and expand solutions for federal and public healthcare programs.
To improve competitiveness, a regional provider-owned health plan needed assistance with: extending network access for its highly mobile membership, containing out-of-network medical cost, and preserving its relationships and reputation with the local provider community.
Claritev analysis showed a property and casualty servicer how it could strengthen its bill review and network services by: using analytics tuned to find wasteful or abusive medical billing practices not identifiable by more automated bill review programs; implementing resolution strategies appropriate for the severity of issues and nature of the provider relationships.
MultiPlan is accepting applications for its Rural Health Grant, offering funding to support hospitals and healthcare providers in rural communities as they expand services, improve access to care, and address local health needs.
MultiPlan’s 2018 Rural Health Grants supported four hospitals in expanding care access and improving outcomes in underserved communities. From dementia education and wound care certification to mobile mammography and heart failure support programs, each recipient used funding to deliver innovative services and strengthen healthcare access where it’s needed most.