Custom solutions for

Your unique needs

The healthcare industry has looked to Medicare as a national benchmark for what is considered to be an acceptable payment for covered medical services.

ClearHealth’s technology and Medicare RBP methodology support your cost management objectives with transparent, industry-accepted reimbursement.

While we aim to help address your out-of-network challenges with our unparalleled Medicare RBP methodology, we also provide supplemental services to round out your entire Network strategy.

Utilize any one or a combination of the ClearHealth solutions to build an end-to-end reimbursement strategy that seamlessly integrates with your claim adjudication system.

  • Out-of-Network claim valuation
    Achieve the highest net retained savings and the least noise with this transparent offering
  • Identify problem billers
    Identify and shut down egregious billing practices
  • Target pricing
    Appropriately price claims based on a chosen level of Medicare
  • Network configuration
    Integrate your various network relationships with Medicare RBP to build a robust cost management solution
  • Partial- to full-network replacement
    Customize payer-specific objectives while enhancing the patient experience
  • Provider service valuation for non-traditional entities
    Create a pricing index and benchmark for nontraditional entities, such as health care cost sharing communities


Insurance carriers

Third party administrators (TPAs)

Stop-loss carriers

Workers’ compensation and auto medical bill review organizations

Health care cost sharing communities

Talk to us about how we can best fit your plan’s needs.

All claims outside of a primary PPO network.

Fully replace the PPO network.

Replace facility or professional providers.

Reliable pricing for your provider agreements.