Payment & Revenue Integrity Solutions
Intelligent solutions that help drive payment accuracy and savings across the entire claims lifecycle.
Payment Accuracy
Cost Containment
We aim to bring clarity and efficiency to eligibility and claims analysis, so they are processed correctly the first time.
Given the challenges healthcare organizations are up against, the ability to quickly and successfully identify errors in healthcare claims has never been more important.
Our approach to payment and revenue integrity is not as a vendor, but as a partner. With services and solutions that span the claims lifecycle and fully customizable solutions to meet your specific needs, we aim to provide long-term transparency that helps reduce waste and drive meaningful savings. We don’t employ one-size-fits-all strategies, and we proactively strive to minimize provider abrasion, aiming for low appeal rates.
$1.8B
Medical cost savings in Payment Integrity in 2025
80M+
Code Combinations
Industry Leader Recognition
Claritev has been recognized as a Leader in the Everest Group Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026, highlighting the company’s leadership in connected payment integrity, responsible AI, and technology-enabled solutions that improve payment accuracy.
Why Pre-payment Integrity Matters More Than Ever
Chief Operating Officer, Jerry Hogge, explores why payment integrity is critical to reducing costs, improving accuracy, and strengthening payer-provider relationships as healthcare claims grow more complex.
Our payment and revenue integrity solutions fall into three distinct categories that cover the entire claims lifecycle.
Pre-Payment Integrity
Whether the claim is for a low-dollar doctor’s visit, a costly hospital stay, or something in between, Claritev has a pre-payment integrity solution to identify potential errors.
Pre-payment solutions include:
Post-Payment Integrity
Claritev’s post-payment integrity services aim to maximize recoveries from other responsible parties and help prevent future overpayments.
Post-payment solutions include:
Revenue Integrity
Find and restore premium dollars owed to you for managing Medicare Advantage members. We help to manage disease statuses and ensure you receive accurate premium payments from the Centers for Medicare and Medicaid Services.
Pre-payment solutions include:
Engaging insights.
New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.
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The Connection Between Better Decision-Making and Healthcare Affordability
Healthcare affordability and access are often viewed as competing priorities—but they don’t have to be. By leveraging data-driven insights, network strategy, and greater price…
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Why Pre-payment Integrity Matters More Than Ever
Claritev’s recognition as a Leader in Everest Group’s 2026 Pre-payment Integrity Solutions PEAK Matrix® Assessment highlights its decades of expertise helping health plans improve…
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Five Considerations for Turning Transparency into Value
Learn five essential strategies for operationalizing healthcare price transparency data, from rate normalization and site-of-care insights to network optimization and affordability-focused decision-making.
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Seeking clarity to inform your complex decisions?
Reach out to Claritev to learn how our solutions aim to go beyond improving affordability and increasing transparency to enabling affordable care for all.