4 Reasons SaaS is Your Ticket to Total Payment Integrity

Jan 4, 2018

Cloud solutions are more secure than you may realize, and offer intrinsic benefits for health plans.

Software as a Service (SaaS) has revolutionized the way technology in business is used. But many health plans are hesitant to rely on SaaS, often because of misconceptions regarding the technology. Why should you consider a cloud-based solution for your payment integrity efforts? Let’s look into what SaaS is, and clear the air on some common concerns surrounding the cloud.

What is SaaS?

Software as a Service is a cloud-based software distribution model that is accessed by users via a web browser. Instead of in-house development teams, health plans can rely upon their SaaS technology vendors, who typically manage the application, including performance, availability, and security.

Security Concerns Are a Non-Issue

Because this is a common misnomer, we’d like to address the issue of cloud-based software security head on. Many industry experts have addressed the myth that cloud-based software isn’t secure. It simply isn’t true that SaaS poses a greater cyber-security risk than technology developed in-house.

We understand organizations that handle sensitive healthcare data are naturally more reluctant to rely on an outside vendor for their payment integrity technology needs. Our recommendation? Question your SaaS vendor extensively on their security protocols. HIPAA compliance demands a specific level of security, and you don’t want to work with a SaaS provider that doesn’t rigorously comply with your health plan’s needs.

How ClarisHealth manages data security:

  • ClarisHealth is SOC 2 certified and pursuing HITRUST certification;
  • ClarisHealth develops software exclusively in-house, nothing is outsourced “off-shore.” That means the data stays within our organization.

SaaS Makes Data More Visible and Available

The need for data to be accessible and correctly managed is felt by every health plan. A SaaS solution, as opposed to something “home-grown,” gives a plan provider top-tier data management capability by streamlining information through a single portal.

Another inherent value of SaaS is data availability. Data is more easily accessible through a cloud-based software program. Therefore, usability is improved because users can access the system on the internet or their mobile devices.

At ClarisHealth, we specifically ensure maximized data visibility through smart work queues, which are customized workflows that give you quick, intuitive access to information you need. Our cloud-based system ensures complete flexibility for our clients.

SaaS Will Save You Money

Software as a Service operates in a subscription model, making it a lower upfront investment for health plans as opposed to in-house software development. When utilizing a SaaS solution, health plans also can free up their internal IT departments to focus on other operational aspects.

Moreover, a SaaS subscription includes software maintenance and ongoing management, which is another cost saver. And, a large user group ensures frequent useful updates to SaaS technology functionality. As this article on IBM’s blog explains, “Costs and effort associated with upgrades and new releases are lower than the traditional model that usually forces the user to buy an upgrade package and install it, or pay for specialized services to get the environment upgraded.”

In addition to the benefits listed above, Pareo Vendor Management maximizes recoveries for users, while optimizing costs. For one client, this amounted to $25 million increase in recoveries.

You’re Still in Control

Concerns surrounding data ownership and control are common with SaaS. But that’s not how the platform works. SaaS solutions seek to optimize function and flexibility for health plans, while off-loading your software management efforts. A true partnership model is in place, allowing you to customize your experience and maximize the value of your payment integrity efforts.

IT professionals shouldn’t worry over SaaS, which mainly seeks to replace software maintenance, freeing up the IT team to focus on other high-demand areas. As this article points out,  “By transferring these responsibilities to the provider, your IT department can focus more on high-value activities that align with and support the goals of your business.”

With the client in control, a SaaS solution provides much quicker implementation times than in-house software development. For a health plan, the time investment of custom software can add up to months, if not years. Reducing the time to benefit is something a health plan should heavily consider when weighing software solutions.

In fact, one of our recent health plan clients told us they were looking at a two-year timeline to develop an on-premise solution. Because a SaaS solution like Pareo™ is continuously being enhanced, the functionality gaps in two years would have rendered their planned on-premise solution woefully inadequate, at least, or potentially useless.

ClarisHealth offers a transparent, comprehensive SaaS solution that can be customized to suit a client’s specific needs. Our integrative, secure platform offers a scalable total payment integrity solution for health plans.


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