One partner. One platform.

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If outdated systems and processes are limiting your health plan’s potential, you need a solution-oriented partner who understands the payment integrity industry.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 10x 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:

Evolving with 2023 Healthcare Payer Technology Trends

What is on the horizon for healthcare payer technology in 2023? Reviewing the trending drivers, restraints, challenges and opportunities so health plans can innovate while minimizing risk.

News & Articles

Webinar: How SIUs Can Embrace Adaptive Business Models

In this on-demand webinar, Karen Wright of Blue Cross of Idaho will share how her organization is preparing for the future by building a modern SIU that relies on proactive and adaptive business models to answer emerging trends in FWA.

Events & Resources

A Vision for Payment Integrity

Season 2: Episode 6 - This season, as we have followed L.A. Care Health Plan's journey building a payment integrity function from the ground up, we've seen them go from a few thousand in unsolicited recoveries to $131 million in ...

Podcast

One partner. One platform.

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 10x 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

Evolving with 2023 Healthcare Payer Technology Trends

Webinar: How SIUs Can Embrace Adaptive Business Models

A Vision for Payment Integrity

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Pareo for Health Plan Innovation

Ready for a change?

Evolving with 2023 Healthcare Payer Technology Trends

For the 2nd Year, ClarisHealth Ranks on the 2022 Deloitte Technology Fast 500

Whitepaper – Technology Adoptions: A Guide for Health Plans

How can your health plan control your prepay strategy?

Webinar: How SIUs Can Embrace Adaptive Business Models

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

A Vision for Payment Integrity

3 Elements Needed to Internalize Payment Integrity