Payment & Revenue Integrity Archives

Beyond Recovery: Designing the Next Generation Payment Integrity Program Webinar graphic with pictures of speakers

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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A Single-Vendor Approach May Improve Your 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.

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Payment Integrity Strategies for Confronting Healthcare Waste and Abuse

Confronting Healthcare Waste and Abuse with Innovative Payment Integrity Strategies

Explore how innovative payment integrity strategies are transforming healthcare by tackling waste and abuse. Discover the key drivers of inefficiencies in U.S. healthcare spending—from administrative overhead to claims errors—and learn how advanced technology, collaboration, and transparency can reduce costs, enhance patient experience, and strengthen provider relations.

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