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The Next Evolution of Payment Integrity
Move beyond recovering payment errors after they happen. This white paper explores how connected payment integrity, powered by responsible AI and advanced analytics, helps health plans proactively prevent errors and improve financial performance.
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Why Pre-payment Integrity Matters More Than Ever
Claritev’s recognition as a Leader in Everest Group’s 2026 Pre-payment Integrity Solutions PEAK Matrix® Assessment highlights its decades of expertise helping health plans improve payment accuracy, prevent costly errors before they occur, and reduce administrative burden through a powerful combination of AI, advanced analytics, and clinical expertise.
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Claritev Rises to Leader Ranking in Everest Group’s 2026 Pre-payment Integrity Solutions PEAK Matrix® Assessment
Recognition underscores the expansion of Claritev’s capabilities and company vision for connected payment integrity, responsible AI, and next-generation payment accuracy solutions.
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On-Demand Webinar: Beyond Recovery: Designing the Next Generation Payment Integrity Program
Recoveries have long defined payment integrity success—but they only tell part of the story. This webinar challenges the traditional recovery-focused approach and introduces a more forward-looking framework centered on prevention, performance, and continuous improvement. Discover how to better evaluate impact, balance pre- and post-pay strategies, and build a smarter, more effective payment integrity program.
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Detecting Infectious Disease Waste & Abuse
Claritev has identified more than $22 million in waste and abuse for clients through its proactive, data-driven approach to payment integrity. By closely analyzing infectious disease billing patterns—including rising trends in RSV and COVID‑19—Claritev helps organizations detect errors early, prevent overpayments, and strengthen protection against emerging sources of waste and abuse.
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eBook: Future of Payment Integrity
Payment integrity in healthcare is evolving faster than ever. Rising costs, complex regulations, and emerging technologies demand a fresh approach. Claritev's new eBook offers a comprehensive roadmap to help your organization navigate these challenges, leverage AI-driven solutions, and partner with experts who deliver measurable results.
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ESRD Premium Restoration Can Have a Large Impact Despite Small Number of ESRD Patients
ESRD premium restoration solutions help ensure Medicare Advantage plans are properly reimbursed for ESRD patients by identifying members with missing ESRD statuses and restoring the premiums. However, because of the low number of ESRD patients, small healthplans often underestimate the potential impact of using an ESRD premium restoration solution and decide against using one. This article explains why they should reconsider.
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The Role of Artificial Intelligence in Payment Integrity
The future of healthcare payment integrity is here, and it’s powered by AI and machine learning. From detecting fraud to streamlining claims processing, these technologies are transforming how payors reduce costs and improve accuracy.
Solution Area: Payment & Revenue Integrity
