Claims Intelligence Solutions

Data-driven, customizable healthcare cost management solutions that can control costs and make affordability possible.

Cost Containment

Pricing Transparency

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

Escalating costs and surprise bills put pressure on both plans and members. Our Claims Intelligence Solutions can clarify the complex with data-driven negotiations, reference-based pricing solutions, and surprise bill services that can reduce spend and help safeguard the member experience.

Claritev is your complete claims intelligence partner, bringing transparency to opaque healthcare costs by leveraging publicly available data to bring insight to light.

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

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

Surprise Bill Services

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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

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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.

Financial Negotiations

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
They (Claritev) are continuously refining and developing the platform to meet my needs.

A Major Healthcare Provider
The Technology Leadership Program has brought my department tremendous value. The well-structured program offers the talented hardworking associates options for their career paths, yet exposes them to high visibility initiatives. Every associate has brought a unique perspective and strong professional skills to the organization.

Bobby Vincent

Senior Information Technology Director
The Technology Leadership Program associates have a tremendous opportunity before them. To have three years to rotate through various departments within Information Technology before deciding which role/area suits them best.  Depending on their choice and interest, they become a unique blend of technologist, business expert and, eventually, corporate leader.

Andrew George

Senior Vice President, Information Technology
One of the great successes of the program has been our ability to identify and develop emerging leaders whom contribute in every facet of our business. It hasn’t been just about growing IT leaders, it’s about maturing business leaders for Claritev.

Ed Ververs

Senior Director, Telecom & Data Center Management
I had the privilege to mentor some of the Technology Leadership Program participants and was fortunate to absorb a member into my team, where he has helped tremendously with new automation techniques. Participants bring in fresh perspectives and extreme enthusiasm to IT here at Claritev. I’m looking forward to adding more.

Vasu Raghunathan

Senior Director of Data & Service Delivery
You have been a great partner from day one. You collaborate with us until we find a resolution. We look forward to a long-standing partnership.

Payment Integrity and Performance Manager
The things we value most about our partnership with Claritev are not just the reliable, efficient delivery of savings through their MSP and ESRD services, but the fact that they are always willing to come to the table to discuss and collaborate on new and innovative solutions that nobody else in the industry has yet to try.

Drew Satriano, VP of Payment Integrity

Highmark, Inc.
In our experience, Claritev has been very responsive with great turnaround times and the findings they’ve presented to SIHO have been accurate and reasonable.

Claims Department

SIHO Insurance Services, Inc.

Engaging insights.

New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.

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