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Step 2:
Payment Intelligence
Our enterprise platform continuously evaluates healthcare claims to identify payment inaccuracies before they become systemic problems.
Red Edits:
High-Confidence Errors
Supported by established industry standards – NCCI edits, AMA CPT guidelines, CMS global surgery rules. These flag payments that should not have occurred and represent clear opportunities for correction.
Gray Edits
Process Irregularities
Billing and payment irregularities indicating process failures or contractual inconsistencies – surfacing systemic issues and driving structural improvements over time.
Case Study: In one review, ClērBlū's platform flagged over $14 million in erroneous claims payments – duplicate billing, unbundled procedures, and coding violations – with more than $3.7 million landing directly on employees through inflated cost-share. Every finding was caught inside the open payment window, when correction is fastest and least disruptive.
Are you getting what you pay for?
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