{"id":987324,"date":"2026-07-30T09:26:22","date_gmt":"2026-07-30T13:26:22","guid":{"rendered":"https:\/\/www.marketnewsdesk.com\/index.php\/claritev-demonstrates-market-leadership-as-federal-no-surprises-act-disputes-reach-record-levels\/"},"modified":"2026-07-30T09:26:22","modified_gmt":"2026-07-30T13:26:22","slug":"claritev-demonstrates-market-leadership-as-federal-no-surprises-act-disputes-reach-record-levels","status":"publish","type":"post","link":"https:\/\/www.marketnewsdesk.com\/index.php\/claritev-demonstrates-market-leadership-as-federal-no-surprises-act-disputes-reach-record-levels\/","title":{"rendered":"Claritev Demonstrates Market Leadership as Federal No Surprises Act Disputes Reach Record Levels"},"content":{"rendered":"<p>        <!--.bwlistdisc { list-style-type: disc }body {font:normal small Arial,Helvetica,sans-serif;color:#000;background-color:#fff;padding:24px;margin:0;} a img {border:0;} h3 {font-size:medium;color:#000;margin:0 0 1em 0; text-align:center;}-->  <\/p>\n<p><b>Claritev Demonstrates Market Leadership as Federal No Surprises Act Disputes Reach Record Levels<\/b><\/p>\n<p><i>New CMS data shows Claritev led all non-payer organizations in federal IDR volume while delivering outcomes above industry averages<\/i><\/p>\n<ul class=\"bwlistdisc\">\n<li><b>Claritev achieved a 20% IDR success rate versus 12% industrywide, increasing to 24% versus 15% in the fourth quarter<\/b><\/li>\n<li><b>Claritev ranked as the market-leading independent non-payer IDR administrator, with volumes exceeded only by the nation\u2019s largest health insurers<\/b><\/li>\n<\/ul>\n<p>MCLEAN, Va.&#8211;(<a href=\"http:\/\/www.businesswire.com\">BUSINESS WIRE<\/a>)&#8211;<br \/>\nClaritev Corporation (NYSE: CTEV), a healthcare technology, data, and insights company focused on making healthcare more affordable, transparent and fair for all, today announced that, according to newly released 2025 data from the Centers for Medicare &amp; Medicaid Services (CMS), the Company handled more federal Independent Dispute Resolution (IDR) claims than any other non-payer participant.<\/p>\n<p>\nClaritev was the leading independent IDR administrator among all non-payer organizations by volume, underscoring its ability to support clients at national scale. Claritev\u2019s broader claims intelligence, contracted network of 1.4 million providers, and financial negotiation capabilities also help clients address eligible claims earlier, reducing the number of disputes that proceed to federal IDR. By helping clients address claims earlier and resolve disputes efficiently when they arise, Claritev supports the No Surprises Act\u2019s central goal of protecting patients from unexpected bills and keeping them out of payment disputes.<\/p>\n<p>\nThe No Surprises Act was designed to protect insured patients from certain unexpected out-of-network bills and limit their cost-sharing responsibility. It established the IDR process so health plans and providers can resolve eligible payment disputes without involving patients or affecting their protected cost-sharing responsibility. Originally forecast to produce fewer than 20,000 payer-provider disputes annually, the federal IDR process now receives more than 100 times the originally projected volume, creating significant complexity and administrative burden across the healthcare industry. Claritev\u2019s newly published <a rel=\"nofollow\" href=\"https:\/\/cts.businesswire.com\/ct\/CT?id=smartlink&amp;url=https%3A%2F%2Fwww.claritev.com%2Finsights%2Fno-surprises-act-updates-and-strategies-to-drive-operational-improvements%2F%3Futm_source%3Dexternal%26utm_medium%3Dweb%26utm_campaign%3Dcompany-press_release%26utm_content%3Dpress-release%26utm_term%3Dweb_company-press_release&amp;esheet=54579797&amp;newsitemid=20260730754826&amp;lan=en-US&amp;anchor=NSA+Trend+Report&amp;index=1&amp;md5=f3b2fa1b1e94fe2a99f0a1f497a70ade\">NSA Trend Report<\/a> found that nearly 50% of the 2025 filings reviewed by the Company raised potential federal eligibility issues.<\/p>\n<p>\nThe new CMS data demonstrates the accelerating scale and financial significance of the federal IDR process:<\/p>\n<ul class=\"bwlistdisc\">\n<li>\nMore than 2.5 million disputes filed in 2025, compared with 1.5 million in 2024<\/p>\n<\/li>\n<li>\n1.4 million disputes filed between July and December 2025, a 16% increase over the first half of 2025<\/p>\n<\/li>\n<li>\nTotal IDR awards exceeded $15 billion in 2025, more than triple the amount awarded in 2024<\/p>\n<\/li>\n<\/ul>\n<p>\nAs dispute volume and awards continue to rise, so do the cost and the complexity of resolving payment disputes across the healthcare system. A well-functioning process helps identify ineligible claims earlier, resolve eligible disputes more efficiently, and reduce unnecessary administrative costs, helping make healthcare more affordable for patients.<\/p>\n<p>\nAs federal IDR volume and complexity have grown, clients have increasingly relied on Claritev\u2019s end-to-end No Surprises Act capabilities. Claritev combines claims intelligence, eligibility review, its contracted provider network, and financial negotiation services to help resolve claims before they enter the federal IDR process. For disputes that cannot be resolved through those capabilities, Claritev supports clients with qualifying payment amount calculation, open negotiation, and federal IDR management.<\/p>\n<p><b>Claritev 2025 Federal NSA\/IDR Performance Highlights<br \/>\n<br \/><\/b><i>Source: CMS Public Use Files and internal Claritev data<\/i><\/p>\n<ul class=\"bwlistdisc\">\n<li>\nClients\u2019 offers were selected in 20% of applicable determinations in 2025, compared with 12% industrywide. In the fourth quarter, that rate increased to 24%, compared with 15% industrywide.<\/p>\n<\/li>\n<li>\nMore than 1 million claims were priced using the qualifying payment amount methodology, demonstrating the scale of Claritev\u2019s support before disputes enter federal IDR.<\/p>\n<\/li>\n<li>\nApproximately 400,000 post-payment disputes were negotiated, helping clients pursue resolution before arbitration.<\/p>\n<\/li>\n<li>\nApproximately 270,000 federal IDR arbitrations were managed, underscoring Claritev\u2019s ability to operate at national scale.<\/p>\n<\/li>\n<\/ul>\n<p>\nClaritev continues to invest in responsible, AI-native capabilities, data, analytics, and workflow orchestration to help clients identify potential issues earlier, resolve more claims before arbitration, and manage disputes that proceed to federal IDR efficiently and consistently.<\/p>\n<p><i>\u201cThe No Surprises Act and federal IDR process were created to protect patients while giving payers and providers a path to resolve payment disputes without placing that burden on the patient,\u201d<\/i> said Travis Dalton, CEO and President of Claritev. <i>\u201cWe are proud that Claritev\u2019s scale, expertise, and technology help our clients manage this increasingly complex process while supporting the law\u2019s fundamental promise to patients.\u201d<\/i><\/p>\n<p><i>\u201cClaritev\u2019s results are grounded in three strengths: deep healthcare pricing and claims experience, longstanding relationships across the healthcare ecosystem, and responsible, data-driven technology that helps us manage rapidly rising filing volumes,\u201d<\/i> said Sean Crandell, SVP and GM of Claims Intelligence at Claritev. <i>\u201cWhile most payers and providers are working to meet the law\u2019s requirements, high volumes of disputes with potential eligibility issues are adding cost and administrative burden to the process. We support efforts to strengthen eligibility controls, encourage meaningful negotiation, and help the federal IDR process operate as intended.\u201d<\/i><\/p>\n<p><b>About Claritev<\/b><\/p>\n<p>\nClaritev is a healthcare technology, data, and insights company focused on delivering affordability, transparency, and quality across the U.S. healthcare system. Led by deeply experienced associates, data scientists, and innovators, Claritev provides technology-enabled solutions fueled by decades of claims expertise. The company leverages advanced analytics and AI to power a robust enterprise platform that delivers clear, actionable insights to support affordability, price transparency, and optimized network and benefits design. By supporting key stakeholders \u2014 including payers, employers, patients, providers, and third parties \u2014 Claritev is dedicated to making healthcare more accessible and affordable for all.<\/p>\n<p>\nClaritev serves more than 750 healthcare payers, over 100,000 employers, 60 million consumers, and 1.4 million contracted providers. For more information, visit <a rel=\"nofollow\" href=\"https:\/\/cts.businesswire.com\/ct\/CT?id=smartlink&amp;url=https%3A%2F%2Fwww.claritev.com%2F&amp;esheet=54579797&amp;newsitemid=20260730754826&amp;lan=en-US&amp;anchor=claritev.com&amp;index=2&amp;md5=3cf89faa592849e5d5f969da763df514\"><b>claritev.com<\/b><\/a>.<\/p>\n<p><img decoding=\"async\" alt=\"\" src=\"https:\/\/cts.businesswire.com\/ct\/CT?id=bwnews&amp;sty=20260730754826r1&amp;sid=flmnd&amp;distro=nx&amp;lang=en\" style=\"width:0;height:0\" \/><span class=\"bwct31415\" \/><\/p>\n<p id=\"mmgallerylink\"><span id=\"mmgallerylink-phrase\">View source version on businesswire.com: <\/span><span id=\"mmgallerylink-link\"><a href=\"https:\/\/www.businesswire.com\/news\/home\/20260730754826\/en\/\" rel=\"nofollow\">https:\/\/www.businesswire.com\/news\/home\/20260730754826\/en\/<\/a><\/span><\/p>\n<p><b>Media Contact<br \/>\n<\/b><br \/>Jen O\u2019Connor<br \/>\n<br \/>VP, Brand Marketing<br \/>\n<br \/><a rel=\"nofollow\" href=\"mailto:press@claritev.com\">press@claritev.com<\/a><\/p>\n<p><b>KEYWORDS:<\/b> Virginia United States North America<\/p>\n<p><b>INDUSTRY KEYWORDS:<\/b> Software General Health Professional Services Data Management Payments Technology Artificial Intelligence Health Technology Health Insurance Data Analytics Insurance Practice Management Health<\/p>\n<p><b>MEDIA:<\/b><\/p>\n<table cellpadding=\"3\" cellspacing=\"3\">\n<tr>\n<td><font face=\"Arial\" size=\"2\"><b>Logo<\/b><\/font><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/mms.businesswire.com\/media\/20260730754826\/en\/2383479\/3\/Claritev-logo-Primary.jpg\" alt=\"Logo\" \/><\/td>\n<\/tr>\n<tr>\n<td><font face=\"Arial\" size=\"2\"><\/font><\/td>\n<\/tr>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>Claritev Demonstrates Market Leadership as Federal No Surprises Act Disputes Reach Record Levels New CMS data shows Claritev led all non-payer organizations in federal IDR volume while delivering outcomes above industry averages Claritev achieved a 20% IDR success rate versus 12% industrywide, increasing to 24% versus 15% in the fourth quarter Claritev ranked as the market-leading independent non-payer IDR administrator, with volumes exceeded only by the nation\u2019s largest health insurers MCLEAN, Va.&#8211;(BUSINESS WIRE)&#8211; Claritev Corporation (NYSE: CTEV), a healthcare technology, data, and insights company focused on making healthcare more affordable, transparent and fair for all, today announced that, according to newly released 2025 data from the Centers for Medicare &amp; Medicaid Services (CMS), the Company handled more federal Independent Dispute &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/www.marketnewsdesk.com\/index.php\/claritev-demonstrates-market-leadership-as-federal-no-surprises-act-disputes-reach-record-levels\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Claritev Demonstrates Market Leadership as Federal No Surprises Act Disputes Reach Record Levels&#8221;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-987324","post","type-post","status-publish","format-standard","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - 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