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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Every Claim Tells a Story: What Your Claims Are Really Saying About Your Business
Every claim contains valuable insights beyond reimbursement. From coding accuracy and documentation quality to operational efficiency and financial performance, claims data can reveal opportunities…
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Five Medical Cost Trends to Watch in 2027
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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.