Enabling the future of payment accuracy.

One Platform, Endless Opportunity

Pareo® is the industry’s only integrative A.I.-enabled payment integrity platform that maximizes health plan avoidance and recoveries at the most optimized cost. What goals can we help you reach?

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SO or Any Module_Recovery Posting (opened batch)

If outdated systems and processes are limiting your health plan’s potential, you need a solution-oriented partner who understands the payment integrity industry.

Why ClarisHealth?

Health Plans Achieve 15x ROI with Pareo

%

Increase in auditor productivity

%

Rate of avoidance and recovery relative to claim spend

%

Improvement in prepay cost avoidance

How We Help Health Plans

What are ClarisHealth Clients Saying?

"ClarisHealth is an industry leader in health plan technology and has created the standard for how payment integrity administrative platforms should work.”

Director of Payment Integrity Operations & Recoveries, Blue Cross Blue Shield Plan

“Key for us was working with ClarisHealth to help design and build a solution that works for both of us. We knew we couldn't have just a canned solution that we had to make our process fit that. We had to have a partner who was willing to customize and really understand our process and build the solution around that.”

Kurt Spear, VP Financial Investigation and Provider Review, Highmark Blue Cross Blue Shield

“Pareo is our single source of truth. For my investigator meetings, I can quickly narrow down to the cases I want to discuss. For the weekly lead and case progress reports I send to clients, we narrowed down the statuses from 30-plus free text to five or six. It's much easier to go into Pareo, download to the spreadsheet, filter and create the roll-up report of what they need to see.”

Senior Director, Program Integrity, Regional Third-Party Administrator

“Pareo® not only allowed us to scale up our third-party supplier program but also gave us the data insights to identify underserved product lines so we could focus our efforts. As a result, we have reduced medical expenses 2.6%.”

Director of Payment Integrity, Regional Health Plan

“With Pareo®, we have the business intelligence necessary to make more informed decisions about what concepts and inventory to insource based on cost-benefit analysis.”

Senior Manager Payment Integrity, State Health Plan

“Pareo allowed us to really ramp up quickly. We went from just a few hundred thousand in annual unsolicited refunds to $30 million in savings and recoveries the first year with Pareo. The second year we did $65 million, then $95 million. Last year, we did $122 million, and we’re on track to do $131 million this year.”

Erik Chase, Director of Payment Integrity, L.A. Care Health Plan

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Industry Perspectives

Every week, our payment integrity and FWA experts analyze industry trends and opportunities to bring fresh perspectives to you. Here’s the latest:

Reduce False Positives in Healthcare Fraud Detection

Part 2 of our series on how the SIU can use artificial intelligence to overcome common challenges. A.I. can reduce the fraud false positive rate to make the most of your limited investigator resources.

News & Articles

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

Live on April 8th, 2021 - Proven strategies from Kurt Spear of Highmark Blue Cross Blue Shield demonstrate how they adopted and continue to scale their use of Pareo to realize their vision for improved efficiency, effectiveness and ...

Events & Resources

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

Season 1: Bonus Episode - How has Highmark Blue Cross Blue Shield achieved an industry-leading 27:1 ROI on their payment accuracy and FWA operations? Listen as Kurt Spear, VP Financial Investigation and Provider Review for Highmark, ...

Podcast

Enabling the future of payment accuracy.

One Platform, Endless Opportunity

Scale Internal Payment Integrity Program

Expand Prepay Cost Avoidance

Enhance Collaboration Between Payment Integrity & SIU

Reduce Provider Abrasion

If outdated systems and processes are limiting your health plan’s potential, you need a solution-oriented partner who understands the payment integrity industry.

Health Plans Achieve 15x ROI with Pareo

Increase in auditor productivity

Rate of avoidance and recovery relative to claim spend

Improvement in prepay cost avoidance

What are ClarisHealth Clients Saying?

"ClarisHealth is an industry leader in health plan technology and has created the standard for how payment integrity administrative platforms should work.”

“Pareo® not only allowed us to scale up our third-party supplier program but also gave us the data insights to identify underserved product lines so we could focus our efforts. As a result, we have reduced medical expenses 2.6%.”

“With Pareo®, we have the business intelligence necessary to make more informed decisions about what concepts and inventory to insource based on cost-benefit analysis.”

Industry Perspectives

Reduce False Positives in Healthcare Fraud Detection

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

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Pareo for Health Plan Innovation

Ready for a change?

Reduce False Positives in Healthcare Fraud Detection

ClarisHealth Selected as a Finalist: NBJ 2021 Best in Business Awards

Whitepaper – Technology Adoptions: A Guide for Health Plans

How can your health plan control your prepay strategy?

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

Webinar – A.I. for Healthcare Fraud Detection

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

The Importance of Partnership When Adopting Technology