Coordination of Benefits (COB) review for healthcare payors involves more investigation than simply validating primacy for other coverage. A significant amount of detective work is needed to drive valid and actionable COB recoveries, especially when patients are newborns.
Claritev explains what revenue integrity is via a short video.
Ben Perryman and Evan Pollack of MultiPlan speak on the combined approach to using both artificial and human intelligence in payment integrity efforts at the NHCAA Institute for Health Care Fraud Prevention’s Annual Training Conference.
Subrogation? What is it and what does it have to do with healthcare insurance? Subrogation, in layman’s terms, means a health plan can be reimbursed by the party whose insured was deemed responsible for an accident or injury.
An estimated $1.2 trillion in healthcare spending is attributed to some form of waste or abuse that leads to overcharges. Payment integrity solutions are tools healthcare payors use to help bring down this staggering number. Claritev discusses what these solutions do.
Claritev takes an innovative approach to ESRD premium restoration, combining machine learning and human intervention to help our clients identify and restore premium dollars for this costly care.
Innovations in AI and machine learning unlock opportunities to eliminate waste, reduce costs, and make healthcare more affordable. Claritev offers the best of both machine power and human power to help Medicare Adavantage plans ensure the accuracy of CMS premiums.
Expanding on one of the top payment integrity trends for 2021, this blog post focuses on growth in Medicare Advantage enrollment and the revenue integrity challenges it brings for health plans.
We explain the many revenue integrity challenges health plans face and walk through a variety of client examples illustrating the breadth of value obtained in premium restoration from our Medicare Secondary Payer Validation and End-Stage Renal Disease Premium Restoration solutions for our health plan clients with varying member sizes.
