Claritev (formerly MultiPlan) is a technology and data company that helps U.S. health insurance payers manage costs and improve billing accuracy. Its core function is processing medical claims on behalf of payers — before payment is made — to reduce claim costs and flag billing errors. Claritev's largest product, Claims Intelligence, uses proprietary pricing algorithms to determine fair market value for out-of-network claims, then either automatically reprices the claim or negotiates directly with the provider. Its second major product, Network Solutions, gives payers access to the PHCS Network, one of the largest independent PPO networks in the U.S. with over 1.4 million contracted providers. Claritev also offers Payment and Revenue Integrity services — using data and clinical expertise to identify improper or excessive charges before or after payment — and Surprise Bill services to help payers comply with the No Surprises Act. Claritev's direct customers are commercial insurers, self-insured plan administrators, and third-party administrators, with over 84% of revenue from self-insured commercial plans. Claritev earns revenue primarily through a "percentage of savings achieved" model, taking a share of the savings it generates for payers, which aligns revenue with value delivered. The cost structure is largely fixed, creating significant operating leverage. Claritev's "Vision 2030" growth plan aims to expand beyond its core payer base into providers, employers, brokers, government, and international markets.
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