Pareo is a unique platform that integrates with other software solutions to provide a comprehensive look at a health plan’s payment integrity processes. Here’s how we approach implementation of enterprise technology.
Just got word that your health plan is adopting Pareo® as a comprehensive payment integrity solution? Here, we pull back the curtain on what all goes into ensuring your health plan and Pareo work together in perfect harmony.
How We (All) Got Here
Our path to Pareo wasn’t all that different than yours. We started with a seemingly-unsolvable problem: How could we get a better view on everything we needed to see in order to effectively manage claims operations? With time, talent and industry expertise we developed a platform designed to transform payment integrity operations and shifted our focus to healthcare technology.
We acknowledge that when you offer folks a solution they’ve never seen before, you have some educating to do. As such, here are some resources from our archives that touch on some of the steps leading to adoption and implementation of Pareo:
Meet the Team
ClarisHealth has a team of experienced professionals dedicated to ensuring your Pareo implementation is a smooth transition. Leading the pre-Implementation team is Ric Stubblefield, Director of Implementations. Ric has overseen implementation of healthcare Software as a Service (SaaS) solutions like Pareo for nearly a decade, managing large teams of project managers and specialists while also serving as the main point of contact for clients during the process.
At ClarisHealth, the Implementation team works closely with Product Support to guide clients through each stage of Implementation and ensure a seamless hand-off after the implementation project is complete. Our post-Implementation team lead is Yaw Agyemang, Director of Product Support. Yaw leads a team of product consultants who ensure that the functionality of Pareo meets the needs of our end users. He has decades of healthcare industry experience and has been a key contributor to shaping Pareo into the solution it is today. Yaw’s team serves as the ongoing point of contact for Pareo users.
Why does this matter? As industry vets, we understand our clients and their frustrations because most of us have either been in your shoes or worked so closely to this industry that we know the long-running pain points you face. Under Ric and Yaw’s leadership, we’ve selected team members that are uniquely devoted to your success:
- Problem-solvers with a results-first focus
- Industry experience
- Clear communicators
- Proven methodology with training every step of the way
Pareo Implementation in 7 Steps
Though we cater our implementation process to meet the needs of each individual client, our decades of experience have taught us to follow a seven-step process to guide each implementation project:
The Implementation team will review the statement of work (SOW) and develop a communication plan that establishes meeting and reporting cadences. At this stage, we will review the major components of each project and identify key deliverables. Known challenges are also acknowledged as our team prepares for discovery.
VP of Operations Kevin Jordan works closely with our Implementation teams in a discovery process that reviews workflows, user access (including role definition), reporting needs and process exceptions. During this phase, we also conduct a technical discovery. This includes the review of data file layouts, frequency of delivery and reviewing claim system integration requirements and file formats. This includes identifying vendor submission file formats.
We conduct data gathering operations throughout the project. Initially, this phase consists of defining roles and rights for each user. Our team will also gather vendor details and load order, creating and reviewing sample reports. Data definitions are created as well as integration file formats. This is the stage when we begin communication with vendors and initiate training.
Configuration and Data Transfer
Configuration is dependant on the process workflows defined in the discovery phase, for both test and production environments. Clients can expect their reporting and dashboards to be created during this phase, configured and loaded into Pareo for review. As such, historical claim, provider and member data files are loaded and mapped. Custom fields are also tested and reviewed in this phase.
In the testing phase, we use sample vendor files and test all loading logic, review validation workflows and test claim system integration. Reports and dashboards, reviewed in the previous phase, are evaluated closely here for accuracy. Also, all user roles are security tested in this phase to ensure accurate access has been granted.
In the test environment, once approved, the client signs off on the work that has been done. This triggers the creation of the production environment. Once the production environment is created, data migration occurs after which a final review is conducted before final sign-off in productions.
The last leg of the process! During go-live, health plan and vendor production files are submitted into Pareo. Any issues found at this stage are actively managed by the Implementation team. Once resolved and when all parties agree that go-live is a success, the client is transitioned to the ClarisHealth customer success team!
Average implementation projects last six to nine months, though this timeframe very much depends on a client’s needs and the SOW. As we implement Pareo at your organization, we have structured our process to include best practices allowing us to act in a secondary role as a software implementation consultant. This approach allows us to offer greater value to clients, who rely on us to lead them through this transition.
This consultative mindset continues post-implementation. We have internal teams solely focused on developing education and other training tools and delivering those to clients in an ongoing manner to support engagement and utilization of Pareo.
NOW'S THE TIME FOR TOTAL FWA PREVENTION
Talk to ClarisHealth about your fraud initiatives and how Pareo® can help.