Claritev Corporation (MPLN)

Overview

MultiPlan Corporation is a prominent entity in the healthcare industry in the United States, renowned for its comprehensive suite of data analytics and technology-enabled cost management, payment, and revenue integrity solutions. Established in 1980 and headquartered in New York, New York, MultiPlan Corporation, in conjunction with its subsidiaries, has dedicated itself to serving a diverse clientele. This includes national and regional insurance companies, Blue Cross and Blue Shield plans, provider-sponsored and independent health plans, third-party administrators (TPAs), self-insured health plans, property and casualty insurers, bill review companies, and various entities engaged in the claim adjudication process. The company's mission revolves around leveraging advanced data-driven algorithms and insights to optimize healthcare costs and enhance the efficiency of the healthcare payment lifecycle.

Products and Services

• Analytics-Based Services:

MultiPlan’s analytics-based services embody a cost-reduction strategy focused on the healthcare sector. By employing sophisticated data-driven algorithms and insights, these services proficiently detect claims over-charges and either negotiate reimbursements or recommend adjustments. This approach not only mitigates unnecessary medical costs but also ensures a fair and accurate assessment of healthcare charges.

• Network-Based Services:

Through its network-based services, MultiPlan offers contracted discounts with a broad spectrum of healthcare providers. In addition to facilitating cost savings through these negotiated rates, the company provides comprehensive outsourced network development and management services. This sows the seeds for more efficient healthcare service delivery and payment mechanisms by establishing a robust link between providers and payers.

• Payment and Revenue Integrity Services:

The payment and revenue integrity services devised by MultiPlan are engineered to prune improper and unnecessary charges that are often overlooked during the claim payment process. Additionally, these services excel in identifying and recovering underpaid premium dollars, thereby securing the financial interests of healthcare payers and ensuring a more transparent and accountable billing landscape.

• Data and Decision Science Services:

At the heart of MultiPlan’s offerings lie its data and decision science services. These services leverage the latest advancements in data science to generate descriptive, predictive, and prescriptive analytics. The insights garnered from these analytics aid in optimizing benefit plan design, supporting critical decision-making processes, improving clinical outcomes, and fundamentally lowering the total cost of care. This analytical prowess enables healthcare stakeholders to navigate through complex data scenarios and emerge with strategic solutions that enhance operational efficiencies.

• Business-to-Business Healthcare Payments and Other Services:

MultiPlan extends its expertise into the domain of business-to-business healthcare payments, alongside offering a variety of associated services. This encompasses a streamlined approach to managing financial transactions between businesses in the healthcare realm, thereby facilitating a more efficient, secure, and transparent financial workflow. The intention behind these services is to consolidate MultiPlan’s position as a comprehensive provider of healthcare cost management solutions, reinforcing its commitment to innovating the way healthcare payments are processed.