The Problem
Hundreds of billions are lost each year
Employers faithfully fund healthcare benefits for their employees. Unfortunately,
the healthcare payment system wasn't designed to provide employers with meaningful oversight.
Payment Errors
Coding mistakes and inconsistent reimbursement
slip through unnoticed.
Contract Violations
Terms negotiated
in good faith, unenforced
in practice.
Hidden Fees
Administrative charges
buried in claim-line detail,
rarely itemized.
Most employers simply assume these costs are unavoidable. They aren't.
Why It's Different
Prevention,
not recovery.
Traditional audit firms review claims annually, months after the fact, and recover a fraction of what was lost. ClērBlū reviews continuously, in hours, and catches errors while they're still correctable.
<10%
Working with historical content and trying to recover from providers – traditional audit firms deliver only 10% of their total findings while charging nearly 50%
The ClērBlū Process
Three stages.
One connected system.
1
Contract Intelligence
Every governing agreement is reviewed for hidden fees, restrictive audit language and compliance gaps – building the rule set the platform runs on.
2
3
Payment Intelligence
Every claim compared against contract terms, 5M+ reference points, and CMS/NPI standards – in hours, not months.
Plan Intelligence
Clean compounding data becomes a queryable asset – fee trends, provider patterns, and benchmarking over time.
What Makes ClērBlū Different
Built to enhance relationships,
not create friction.
Relationship First
Designed to enhance –
not damage – relationships between employers, TPAs
and providers
Real-Time Oversight
Identify issues in a no-blame process while corrections
are still easy
Complete Documentation
Every finding is thoroughly documented as to the why and how it became an error