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 identify opportunities for new revenue growth. We don’t employ one-size-fits-all strategies, and we proactively strive to minimize provider abrasion, aiming for low appeal rates and meaningful savings.
5%
Average Savings
30M+
Code Combinations
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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Infographic: The Rise of Intelligent Healthcare
Healthcare systems are under growing pressure from inefficiencies and rising costs. This brief explores how strategically embedding responsible AI across the healthcare ecosystem can…
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The Transparency Conundrum
As healthcare pricing becomes more transparent, brokers and employers face new challenges and opportunities. This white paper outlines how to turn data into decision-grade…
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Better Decisions Start Here: How TPAs Can Turn Insight Into Impact
Dallas Scrip draws on decades of experience in the TPA and healthcare space to show how actionable insight—not just transparency—drives smarter decisions, lower costs,…
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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.