Revenue Integrity
Translating data into potential action with
innovative and effective premium restoration solutions.
Revenue Protection
Data-Driven Approach
End-to-end revenue integrity solutions, powered by data and amplified through experience.
When premiums don’t align with membership data, the path to revenue can become opaque. Claritev’s Revenue Integrity solutions bring clarity to this complexity for Medicare Advantage plans. Our solution can work to recover premium dollars already earned while helping to prevent future underpayments.
We take a partnership-oriented approach to improving revenue integrity, prioritizing transparency as our team works to identify issues, coordinate updates, and reconcile adjustments.
With deep experience navigating CMS processes and a focus on bringing insight to light, we can help restore revenue, reduce friction, and bring confidence back to premium payments.
What’s new in revenue integrity:
Potentially Restoring millions for your Medicare Advantage plan
Correctly paid Medicare Advantage premiums are a critical source of revenue for many health plans. Incorrectly paid premiums can result in millions of dollars in lost revenue. Download our eBook to find out how you can take charge of your premium revenue.
Supporting revenue integrity with data-driven solutions and expertise.
Medicare Secondary Payer Validation
Claritev’s MSP Validation solution helps Medicare Advantage plans quickly correct MSP inaccuracies, resolve primacy errors, and recover millions in underpaid premiums using secure, CMS-ready technology and expert support.
End-Stage Renal Disease Premium Restoration
Our ESRD Premium Restoration solution helps Medicare Advantage plans identify members with missing or inaccurate ESRD status, validate documentation, and recover underpaid premiums through advanced analytics, CMS collaboration, and a transparent, results-driven approach.
Engaging insights.
Claritev insights, resources, and case studies.
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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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How can Claritev help create clarity and transparency in an effort to improve revenue integrity?
Learn how Claritev can help maximize recoveries and prevent overpayments with data-driven solutions.