Payment & Revenue Integrity Solutions
Intelligent solutions that help drive payment accuracy and savings across the entire claims lifecycle.
Payment Accuracy
Cost Containment
The Opportunity to Reduce Payment Risk and Improve Performance.
Healthcare organizations face increasing pressure to control costs and improve accuracy. Claritev can bring greater clarity and efficiency to eligibility and claims analysis, helping organizations improve first-pass claims accuracy and identify payment errors earlier in the process.
Our approach to payment integrity goes beyond traditional vendor relationships. By combining solutions that span the claims lifecycle with a tailored, provider-friendly approach, we can help reduce waste, improve transparency, and uncover opportunities for meaningful savings.
Claritev’s payment integrity solutions also help identify billing errors and patterns that may indicate fraud, waste, and abuse. Through advanced analytics, provider intelligence, and expert review, we provide greater visibility into payment risk and opportunities to reduce the risk of improper payments before they occur.
$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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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.