Claritev and Kinetiq Health Enter Into Strategic Agreement to Strengthen Cost Management and Advance Claims Surveillance and Diagnostic Certainty

Key Terms

claims surveillance medical

Claims surveillance is the ongoing monitoring and review of insurance or healthcare reimbursement claims to spot errors, fraud, unusual patterns, or rising costs. For investors, it matters because effective surveillance reduces unexpected losses, improves reserve accuracy and compliance, and signals whether a company is controlling costs — like a security camera or checklist that helps prevent theft and mistakes before they become expensive problems.

diagnostic certainty medical

Diagnostic certainty measures how confident doctors, researchers or regulators are that a test result or medical diagnosis is correct, based on the quality of the evidence, repeatability of the test, and clinical context. For investors it matters because higher diagnostic certainty typically means clearer regulatory paths, stronger demand from clinicians and payers, lower legal risk, and a more predictable market for diagnostic products or treatments—like relying on a weather forecast you trust when planning a trip.

risk stratification medical

Grouping people, projects or assets by their likelihood of a negative outcome—such as disease progression, regulatory problems, loan default or product failure—so decisions can be tailored to each group's risk level. Like sorting mail by urgency, risk stratification helps investors gauge which opportunities are safer or more speculative, adjust expected returns, prioritize resources, and estimate how likely different financial or regulatory outcomes are.

second opinions medical

A second opinion is an independent review by another qualified expert—such as a doctor, consultant, auditor or analyst—to confirm, challenge or add nuance to an original diagnosis, valuation or recommendation. For investors it matters because an extra review can uncover overlooked risks, validate assumptions, or change expected outcomes—like getting a second mechanic’s take before buying a used car—helping inform buy, sell or hold decisions and reducing costly surprises.

centers of excellence medical

Centers of excellence are specialized teams or departments within an organization that focus on developing and applying expert knowledge or skills in a particular area. They serve as hubs for best practices, innovation, and high-quality performance, much like a master chef’s kitchen dedicated to perfecting a specific cuisine. For investors, these centers can signal a company’s commitment to excellence and innovation, potentially influencing its long-term success and stability.

The strategic relationship links Claritev’s BenInsights^® with Kinetiq Health’s healthcare risk management services to help reduce high-cost medical and pharmacy spending and support members during complex care.

MCLEAN, Va.--(BUSINESS WIRE)-- Claritev Corporation (“Claritev” or the “Company”) (NYSE: CTEV), a technology, data and insights company focused on making healthcare more affordable, transparent, and fair for all, today announced a strategic relationship with Kinetiq Health, a healthcare risk management organization specializing in claims surveillance, diagnostic certainty, and cost intervention strategies.

Rising medical and pharmacy costs are often driven by a small number of complex, high-cost claims that are difficult to identify and manage early. Through the strategic relationship, Kinetiq Health’s services will be integrated into Claritev’s BenInsights analytics platform, providing employers, brokers, third-party administrators (TPAs), and health plans with a structured approach to identifying emerging high-cost risks, supporting diagnostic accuracy, and improving financial outcomes.

The combined offering delivers monthly medical and pharmacy claims surveillance, risk stratification, and intervention support from clinical and financial experts. Clients also gain access to Kinetiq Health’s Second Opinion Program, which facilitates second opinions from leading centers of excellence for complex conditions to help confirm diagnoses, clarify treatment plans, and reduce unnecessary procedures. Together, these capabilities support proactive claims management, renewal preparation, and informed benefit plan design and contribute to significantly lower claims trend. From 2020-2024, Kinetiq Health clients’ average healthcare claims trend was held to 2.48%, compared to an industry average of 8% over the same period.

“Claritev and Kinetiq Health share a commitment to improving affordability while supporting members through complex healthcare journeys,” said Travis Dalton, Chairman, CEO and President of Claritev. “By combining BenInsights analytics with clinical and financial expertise, this strategic relationship aims to enable earlier identification of high-cost risks, more informed decision-making, and reduced avoidable spend.”

“Our strategic partnership with Claritev represents a pivotal step in helping brokers and employers translate data into meaningful action,” said Jim Harenberg, President of Kinetiq Health. “By layering clinical consulting on top of Claritev’s powerful BenInsights platform, we can turn analytics into measurable outcomes—driving healthier employees, smarter plan decisions, and substantial cost savings for organizations across the board.”

Claritev and Kinetiq Health will help deliver value across three core areas:

• Earlier identification of high-cost risk: BenInsights analytics help improve visibility into emerging medical and pharmacy risks, supporting earlier identification and more informed decision-making.
• Greater diagnostic confidence for complex cases: Access to expert second opinions helps confirm diagnoses and clarify treatment plans, reducing uncertainty, unnecessary procedures, and avoidable care variation.
• Improved cost management and financial performance: Data-driven strategies support better management of high-cost claims, more effective prescription drug spending, and stronger leverage in PBM negotiations, renewals, and benefit plan design.

About Claritev

Claritev is a healthcare technology, data, and insights company focused on delivering affordability, transparency, and quality to the U.S. healthcare system. Led by a team of deeply experienced associates, data scientists, and innovators, Claritev provides cutting-edge solutions and services fueled by over 40 years of claims experience. Claritev leverages world-class technology and AI to power a robust enterprise platform that delivers meaningful insights to drive affordability and price transparency and optimizes networks and benefits design in healthcare. By developing purpose-built solutions that support all key stakeholders — including payers, employers, patients, providers, and third parties — Claritev is dedicated to making healthcare more accessible and affordable for all.

Claritev serves more than 700 healthcare payers, over 100,000 employers, 60 million consumers, and 1.4 million contracted providers. For more information, visit claritev.com.

About Kinetiq Health

Kinetiq Health redefines how organizations manage employee health and benefits through transformative health care risk management. Combining predictive analytics with in-depth clinical insight, Kinetiq Health empowers employers to make smarter, data-driven decisions that lead to healthier workforces and lower plan costs.

Powered by a multidisciplinary team of health experts — including registered nurses, pharmacists, analysts, dietitians, social workers, and certified health coaches — Kinetiq Health continuously reviews medical and pharmacy claims to uncover emerging risks, support accurate diagnoses, and recommend targeted actions that improve outcomes and control costs. The organization’s data-driven approach and Diagnostic Certainty Program provide structured second-opinion access to leading centers of excellence for complex conditions, helping organizations reduce unnecessary procedures and enhance member support. Kinetiq Health’s solutions are designed to improve financial performance, inform benefit design, and promote healthier outcomes for both members and plan sponsors. For more information, visit www.KinetiqHealth.com.

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Claritev Media Relations

Jen O’Connor

VP, Brand Marketing

Claritev

press@claritev.com

Kinetiq Media Relations

Joshua Schumacher

Director of Marketing Communications

Kinetiq

jschumacher@apexbg.com

Claritev Investor Relations

Todd Friedman

VP, Investor Relations

Claritev

866-909-7427

investor@claritev.com

Source: Claritev Corporation