Pro Pricer®
The next-generation data solution that can bring clarity to your out-of-network cost management programs.
Pricing Optimization
Cost Management
Data-driven, configurable intelligence that removes the guesswork from cost management.
Out-of-network cost management typically involves weighing savings against health plan member satisfaction. Networks offer protection from balance billing but typically deliver lower savings than more aggressive options.
Claritev’s Pro Pricer can eliminate the guessing game, blending the best of all available solutions and striking a balance between your savings goals and member satisfaction on a claim-by-claim basis.
Clarity and configurability that enables savings.
Implementation
Implementation is easy, especially for payers already accessing two or more of Claritev’s out-of-network solutions.
Customization
Configure Pro Pricer according to your out-of-network cost management goals and preferences, and it can be customized so that it can quickly pivot based on market conditions.
Optimization
With Pro Pricer, our machine learning models are consistently learning over time to adjust based on claims experience, helping to refine pricing decisions and aiming to support improved outcomes in the future.
Engaging insights.
New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.
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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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A Single-Vendor Approach May Improve Your Payment Integrity Program
A Single-Vendor Approach May Improve Your Payment Integrity Program Brad Ross Senior Vice President, General Manager Payment & Revenue Integrity, Claritev In 2024, spending…
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Q&A with Kinetiq Health’s Chief Clinical Officer
Sarah Michaels, Chief Clinical Officer of Kinetiq Health, makes the opportunity clear: healthcare can use data to make decisions that lead to better outcomes…
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How can Pro Pricer help modernize your out-of-network pricing and manage the cost of care?
Reach out to learn how our solutions can go beyond reducing costs and increasing transparency by enabling affordable care for all.