Reference-Based Pricing Solutions
Fair, transparent, and defensible pricing that can bring savings and affordability into focus.
Fair Reimbursement
Data-Driven
Aim to reduce costs, enable engagement, and address pricing gaps with data-driven RBP solutions.
In an environment in which healthcare prices are often opaque, having a partner that can bring clarity to costs can make all the difference — especially when it comes to making healthcare affordable.
Our reference-based pricing (RBP) services offer flexible, cost-effective, data-driven solutions aimed at reducing healthcare costs.
Reference-based pricing solutions and services designed to reduce balance billing, manage costs, and empower members.
Data iSight®
Our alternative to U&C or Medicare-based reimbursement recommendations for out-of-network (OON) charges that delivers consistent, transparent results with high provider acceptance.
Medicare-Based Pricing
Claritev’s Medicare-Based Pricing service combines Medicare benchmarks with publicly available claim data to deliver fair, transparent, and defensible reimbursement — filling Medicare pricing gaps with confidence and consistency.
Vistara™
A single solution that either exclusively offers reference-based pricing for facility and professional claims or integrates the PHCS Network and reference-based pricing to deliver transparency, insight, and access aimed at reducing the cost of care for employers and their members.
Pro Pricer®
Claritev’s data-driven, configurable solution that brings clarity to out-of-network cost management programs to enable savings.
Engaging insights.
New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.
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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…
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The No Surprises Act at a Crossroads: From Protection to Performance
No Surprises Act independent dispute resolution (IDR) volume is driving healthcare administrative costs—it’s time to shift from policy execution to system optimization. Explore how leaders…
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On-Demand Webinar: Final Rule – Navigating NSA Independent Dispute Resolution Operations
CMS’s latest IDR Operations Final Rule brings important changes to the No Surprises Act dispute process. This webinar highlights key updates, workflow impacts, and…
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How can Claritev’s data-driven approach to reference-based pricing make a difference for you?
Reach out to learn how our solutions can go beyond reducing costs and increasing transparency by enabling affordable care for all.