Government

Networks

Adequacy Confidence

Operational Efficiency

Medicare Advantage and Medicaid-compliant networks built for efficiency and scale.

For Medicare Advantage and Medicaid plans facing strict regulatory requirements, tight timelines, or geographic expansion, Claritev delivers custom or ready-made provider networks that help accelerate market entry and strengthen access to care.

Our Medicare Advantage and Medicaid solutions aim to get plans to market quickly, improve payment accuracy and reduce administrative lift through credentialing and automated provider operations.

Our deployment-ready infrastructure — paired with Claritev’s longstanding history of Network expertise — helps plans launch quickly, reduce administrative burden, and operate with confidence from day one.

From credentialing and network adequacy monitoring to provider data management, we can help streamline operations while supporting payment accuracy and regulatory alignment.

A trusted partner for more than 45 years, Claritev supports annual filings, NCQA-standard credentialing, and ongoing compliance oversight to help government plans maintain performance and meet evolving CMS and state expectations.

Our government network solutions aim to enhance transparency, improve access, and protect premium dollars.

Claritev’s Medicare Advantage solution delivers deployment-ready CMS-compliant provider networks that help accelerate market entry, reduce costs, and increase access to care while looking out for compliance risks.

This solution leverages Claritev’s extensive provider relationships to build Medicaid-ready networks with NCQA-standard credentialing and ongoing network adequacy support.

Credentialing, provider data management and repricing services help to minimize administrative burden for commercial, Medicare Advantage, and Medicaid plans while supporting payment accuracy and savings.

Claritev insights, resources, and case studies.

  • 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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Pattern

Learn how Claritev delivers the flexibility and nationwide reach you need to build credentialed, cost-effective access.