Vistara™
Integrating the PHCS Network and reference-based pricing into a single solution to help drive cost savings and satisfaction.
Network Access
Transparency
Potentially reduce the total cost of care while maintaining member satisfaction with our combined RBP and network solution.
Claritev’s Vistara solution combines the PHCS Network for professional claims with transparent reference-based pricing (RBP) for facility claims to help employers gain control of healthcare costs while also providing access to cost-efficient, quality care for their members.
Vistara uses Medicare as a starting point to determine a clear and transparent price for medical services. It engages both the plan member and provider, aiming to make the most of the member’s benefit plan.
75.6%
Average Medical Claim Discount
99%
Provider Acceptance Rate
82:1
Average ROI
Proprietary PHCS Network
Gain access to our proprietary, NCQA-accredited national PHCS Network to create a more sustainable model of care aimed at increasing access.
Members
Members can gain confidence with national access to a curated
network of quality providers.
Employers
Employers can gain control with pricing transparency.
Providers
Providers may engage more efficiently through clear communication and reduced administrative burden.
Working to engage members and providers
to create clarity.
Claritev knows how to involve providers and members throughout the care process –
a key factor in helping employers control healthcare costs.
For Members
Vistara can deliver clarity and peace of mind.
- Access to our proprietary PHCS Network
- A mobile app to compare providers by cost, quality, and likelihood of rate acceptance
- Patient Advocacy Center (PAC) for billing questions or concerns
For Providers
Vistara can deliver transparency and access.
- Member steerage even without a provider contract
- Transparent communication throughout the entire healthcare process
- Easy-to-use provider portal with relevant information
Working to create clear
value for brokers.
Premier Broker Program
Give your clients a seamless solution that can reduce the cost of care while elevating the group and member experience while streamlining your own operations at the same time.
Claritev’s Premier Broker Program can help brokers grow
their books faster and win bigger.
Engaging Insights
New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.
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How Carlinville Hospital Improved Financial Performance Through Denial Visibility, Revenue Cycle Prioritization, and Operational Alignment
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Medicare Advantage Expansion Strategy
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How can Vistara help reduce your total cost of care and maintain the member experience?
Reach out to learn how our solutions can go beyond reducing costs and increasing transparency by enabling affordable care for all.