Third Party Administrators

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.

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.

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Connect with Claritev to explore how integrated negotiation, editing, and payment solutions can strengthen the plans you administer.