End-Stage Renal  Disease Premium  Restoration

Work to recover the ESRD premiums your plan has earned, with accurate identification and transparent restoration.

Premium Restoration

Revenue Protection

Potentially recover underpaid premiums and avoid missing out on millions of additional premium dollars.

Members with end-stage renal disease, or ESRD, are some of the most complex and costly in a Medicare Advantage population. However, many organizations struggle with incomplete or inaccurate ESRD documentation.

Claritev can bring clarity and transparency to ESRD confusion, with an ESRD Premium Restoration solution that can uncover missed opportunities by finding members with missing or incorrect ESRD status.

This can result in potentially restored premium dollars, which can translate into more affordable healthcare.

Our ESRD Premium Restoration solution uses advanced analytics and trusted relationships with CMS and care facilities to:

Validate data
Close documentation gaps
Support accurate premium reconciliation

Delivering ESRD clarity with measurable premium restoration results.

Built for Medicare Advantage payment integrity teams, our approach is transparent, collaborative, and results-driven, helping plans regain control of ESRD data and potentially recover millions in underpaid premiums with confidence.

The results speak for themselves.

Delivering an average ESRD adjustment worth

$70,000

per update.

Engaging insights.

New ideas, deep experience, and fresh perspectives for the healthcare ecosystem.

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