Third Party Administrators
How Claritev helps TPAs reduce costs, streamline operations, and deliver greater value to clients.
Deliver savings. Simplify administration. Strengthen trust.
Third Party Administrators (TPAs) operate in an increasingly complex healthcare environment. Client expenses continue to rise, claim variability remains difficult to predict, and administrative requirements are becoming more demanding over time.
Clients rely on TPAs to control costs while preserving the member experience, all without increasing operational burdens.
We support TPAs with tech-enabled solutions that span pricing, editing, negotiation, and payment. Combining advanced analytics and decades of expertise, Claritev helps you:
• Reduce improper billing and overpayments
• Improve payment accuracy before and after claims are processed
• Streamline electronic payment workflows
• Protect members from balance billing
• Deliver transparent, defensible savings
When you need to expand capabilities without expanding overhead, Claritev becomes an extension of your team.
Featured Solutions
Targeted solutions created to complement and strengthen your existing capabilities.
Claritev Payments
Claritev Payments simplifies payments while helping enhance provider relationships, ensuring scalability and add bottom-line value. From streamlined 1099 demands to enhanced fraud protection and security, we help elevate the payment process from start to finish.
Advanced Code Editing
Advanced Code Editing (ACE) uses intelligent automation and expert clinical review to detect coding errors in both in-network and out-of-network claims.
Financial Negotiations
We help negotiate claim-specific reductions on low- and high-dollar facility and professional claims to help deliver savings reliably and increase affordability.
Creating clear paths to value for Third Party Administrators.
Claritev insights, resources, and case studies.
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On-Demand Webinar: Beyond Recovery: Designing the Next Generation Payment Integrity Program
Recoveries have long defined payment integrity success—but they only tell part of the story. This webinar challenges the traditional recovery-focused approach and introduces a…
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The No Surprises Act at a Crossroads: From Protection to Performance
No Surprises Act independent dispute resolution (IDR) volume is driving healthcare administrative costs—it’s time to shift from policy execution to system optimization. Explore how leaders…
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On-Demand Webinar: Final Rule – Navigating NSA Independent Dispute Resolution Operations
CMS’s latest IDR Operations Final Rule brings important changes to the No Surprises Act dispute process. This webinar highlights key updates, workflow impacts, and…
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Are you a TPA looking to expand your offering while simplifying administration for your clients?
Connect with Claritev to explore how integrated negotiation, editing, and payment solutions can strengthen the plans you administer.