Claims Intelligence Solutions

Cost Containment

Pricing Transparency

With costs rising, transparent and data-backed negotiation are essential.

Solutions elevated by expertise and innovation that can make a bottom-line difference for you and potentially lower the cost of care.

Reference-
Based Pricing Solutions

Our reference-based pricing (RBP) services offer flexible, cost-effective, data-driven solutions aimed at reducing healthcare costs.


Surprise Bill Services

State and federal surprise billing regulations add new levels of complexity to the payment of healthcare claims. From identifying surprise bills to offering support during arbitration, Claritev’s services address the entire lifecycle of a surprise bill.


Negotiation Services

Claritev provides comprehensive, clear, and data-driven agreements that help ease the burden of balance billing. Our team of experienced negotiators and support staff bring clarity to the process, with an average turnaround time of just 3.2 days.

  • In a remote community like ours, we do not have local access to every type of medical specialist. The MAVEN Project gives our providers a trusted resource when a patient’s care would benefit from specialist input and helps us make better-informed decisions about whether someone truly needs to travel off island. This grant means we can continue that support for another year.

    Chief Executive Officer, Kodiak Community Health Center

    Olivera Wilson

  • When someone comes through our doors with a serious or uncertain condition, every minute matters. Having portable ultrasound available at the bedside will give our clinicians another important tool to understand what is happening and make decisions faster. We are incredibly grateful to Claritev Cares and to our community for helping us get this across the finish line.

    Chief Executive Officer, Fairfield Memorial Hospital

    Andy Flemer

  • Rural healthcare organizations know exactly what would make a difference for their patients. The challenge is often finding the resources to make it happen. These grants help close that gap. One will put important diagnostic technology directly at the bedside, and the other will help patients benefit from specialist expertise without automatically having to leave their island community.

    Executive Director, Claritev Cares

    Andrew Loudner

  • Accurate payments help reduce unnecessary administrative costs, support stronger payer-provider relationships, and contribute to a healthcare system that promotes affordability and predictability for the people who depend on it every day.

    Chief Operating Officer, Claritev

    Jerry Hogge

  • Claritev’s broad pre-pay value chain coverage and clinical negotiation experience give it a foundation to support payers on upstream payment accuracy needs.

    Vice President, Everest Group

    Ankur Verma

  • The grant money we received from Claritev was used to support additional resources that allow our respiratory therapists to spend more time empowering and educating patients.

    Lisa Emery

    Director, New River Health Association Breathing Center

  • These resources were created to help military and veteran caregivers more easily understand options for meaningful mental health care for themselves and their families. Caregivers shoulder extraordinary responsibilities every day, and they deserve clear, trusted guidance that helps them navigate complex healthcare systems with greater confidence.

    Steve Schwab

    Chief Executive Officer, Elizabeth Dole Foundation

  • This collaboration (with the Elizabeth Dole Foundation) reflects a shared commitment to helping military and veteran caregivers navigate mental healthcare more clearly and confidently. These families have given so much in service to our country, and they deserve resources that are practical, accessible, and grounded in empathy.

    Carol Nutter

    Board Chair of Claritev Cares & Chief People Officer, Claritev

  • Your team is great at building trust. I have had nothing but a positive and efficient experience.

    Manager

    Large Midwest health plan

  • These are really important things that we wouldn’t be able to do without a partner like Claritev because, again, we want to look at this stuff holistically across carriers. It would take me four times as long to go into every health plan and do this kind of analysis.

    Executive Vice President

    Large, regional consulting firm/insurance brokerage

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    Healthcare transparency data offers significant potential, but turning it into actionable insights requires the right strategy. Learn how healthcare pricing intelligence helps organizations improve…

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    Stopping overpayments before they occur can generate significantly greater value than recovering them after the fact. Explore the advantages of pre-pay payment integrity programs…

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  • Beyond Cost Containment

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