Press Release: Leading Payment Integrity Technology Company Launches New Solution to Combat FWA

Press Release: Leading Payment Integrity Technology Company Launches New Solution to Combat FWA

ClarisHealth VP of Program Integrity Mark Isbitts envisions a “better way” to FWA management, announces release of Pareo Fraud at 2019 NHCAA Conference

NASHVILLE, Tenn., October 21, 2019 – At the annual NHCAA Anti-Fraud Training Conference in Nashville last week, ClarisHealth’s Vice President of Program Integrity, Mark Isbitts, announced a new technology product for the company. The new product line is known as Pareo Fraud, and the Nashville-based company will be partnering with its customers on the market rollout of the initial release. 

“There’s truly nothing else like it on the market,” says Isbitts, a 25-year healthcare veteran. “At least 10-percent of healthcare claims are paid inaccurately, and Pareo Fraud can help health plans reduce fraud, waste and abuse losses by 40-percent in the first year.”

Isbitts has worked for some of the leading healthcare payment integrity vendors, where he was responsible for launching new products into the market. “This solution will enable health plans to aggressively and comprehensively tackle FWA through advanced and integrative technologies, and facilitating root cause analysis between the SIU and other payment integrity disciplines such as Coordination of Benefits (COB), Provider Bill Audit and Data Mining.” 

This holistically-minded approach to payment integrity technology, touted as Total Payment Integrity™ by the company, is a natural and in many ways client-demanded next step for ClarisHealth, creators of Pareo. “We went to market five years ago with Pareo, and the solution we’ve created has been so successful, our clients are asking us to apply those concepts to other lines of  business,” says ClarisHealth CEO Jeff McNeese. 

The product will roll out in phases, with a case management solution being the initial offering. Isbitts says the impact of Pareo Fraud could be “major” in an industry that still relies on old and outdated technology to combat increasingly sophisticated fraud, waste and abuse schemes. 

“We’ve talked to many health plans that feel limited by the technology solutions that are currently available, some of which have been used for 30 years. We feel confident that we can leverage the success of Pareo, coupled with advanced analytics and artificial intelligence, and apply that same experience to the FWA market,” says Isbitts. 

Last Tuesday, during the Welcome Reception in NHCAA’s Anti-Fraud Expo hall, attendees were abuzz at the implications of such a solution. “It’s exciting to sit in front of health plan leaders and introduce a solution to a decades-old problem,” says Isbitts, who made the product announcement official during one of the show’s Fraud Side Chat presentations.  

For future and current Pareo clients, some of whom hope to adopt Pareo Fraud in the coming year, the value is clear, according to Jason Medlin, VP of Marketing for ClarisHealth.

 “We’ve met with health plan leaders who are asking us to solve the problem of siloed fraud, waste and abuse efforts. This market is ready to move away from outdated methods and for the first time, they’ll have a robust and integrated technology solution to truly manage the growing demands on SIU departments,” commented Medlin.

Mark Isbitts, VP of Program Integrity

Pareo Fraud will seamlessly integrate with the Pareo suite of solutions to offer health plans an aggressive and powerful platform to combat fraud, waste and abuse, while also remaining easy to implement. To learn more about this new technology solution, contact Mark Isbitts directly at misbitts@clarishealth.com

 

About ClarisHealth

ClarisHealth is the answer to the health plan industry’s siloed solutions and traditional models for identification and overpayment recovery services. We provide health plans and payers with total visibility into payment integrity operations through our advanced cost containment technology Pareo®. Pareo®enables health plans to maximize avoidance and recoveries at the most optimized cost for a 10x return on their software investment. For more information please visit us at www.clarishealth.com

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ClarisHealth Hires Mark Isbitts as Vice President of Program Integrity

ClarisHealth Hires Mark Isbitts as Vice President of Program Integrity

25-year industry veteran will extend ClarisHealth’s strategic direction in growing and building market-leading technology solutions for health plans.

NASHVILLE, Tenn., July 2, 2019 – ClarisHealth, a leading provider of advanced payment integrity technology for health plans, hired Mark Isbitts as Vice President of Program Integrity. Isbitts will  create and launch new products, increase market awareness, position products and cultivate market opportunities.

Isbitts brings with him over 25 years experience in healthcare, including 15 years in product management leadership. He has worked for some of the leading healthcare Payment Integrity vendors where he launched several new products into the market. 

In his roles immediately prior to joining ClarisHealth, Isbitts helped several mid- to large clients in the healthcare payer technology space with their product management and ideation processes, go to market strategy and overall positioning, and led a team that managed a product portfolio of over $155 million.

“We’re very excited to have Mark on board,” says Jeff McNeese, CEO of ClarisHealth. “His depth of experience, knowledge and product management capabilities will complement our growing team of seasoned executives and help us deliver on new products and solutions to our expanding base of health plan clients.”

Isbitts holds a B.S. from the University of Michigan and a Master’s in Healthcare Administration from Mercer University. He lives in the greater Atlanta area with his family.

“ClarisHealth is on the forefront of technology-enabled payment integrity and FWA solutions,” says Isbitts. “In many respects, the company is charting a new course for how these services have historically been delivered. I very much look forward to helping ClarisHealth deliver one-of-a-kind solutions that help health plans maximize medical savings most cost effectively.”

About ClarisHealth

ClarisHealth is the answer to the health plan industry’s siloed solutions and traditional models for identification and overpayment recovery services. We provide health plans and payers with total visibility into payment integrity operations through our advanced cost containment technology Pareo®. Pareo®enables health plans to maximize avoidance and recoveries at the most optimized cost for a 10x return on their software investment. For more information please contact us via the button below.

 

ClarisHealth Achieves HITRUST CSF® Certification to Manage Risk, Improve Security Posture and Meet Compliance Requirements

ClarisHealth Achieves HITRUST CSF® Certification to Manage Risk, Improve Security Posture and Meet Compliance Requirements

HITRUST CSF Certification validates ClarisHealth is committed to meeting key regulations and protecting sensitive information.

NASHVILLE, Tenn., April 17, 2019 – ClarisHealth, a leading provider of advanced payment integrity technology for health plans, today announced its solution Pareo® and supporting infrastructure has earned Certified status for information security by HITRUST.

HITRUST CSF Certified status demonstrates that the organization’s payment integrity solution Pareo® has met key regulatory requirements and industry-defined requirements and is appropriately managing risk. This achievement places ClarisHealth in an elite group of organizations worldwide that have earned this certification.

“ClarisHealth is committed to achieving the highest levels of data security and regulatory compliance with respect to sensitive healthcare information,” says Jim Weathersby, chief technology officer for ClarisHealth. “Nowhere is this more evident than our achievement of the HITRUST CSF Certification. This certification is the gold standard when it comes to sensitive information protection and we are very pleased to offer this added level of assurance for our customers.”

By including federal and state regulations, standards and frameworks, and incorporating a risk-based approach, the HITRUST CSF helps organizations address these challenges through a comprehensive and flexible framework of prescriptive and scalable security controls.

“HITRUST has been working with the industry to ensure the appropriate information protection requirements are met when sensitive information is accessed or stored in a cloud environment. By taking the steps necessary to obtain HITRUST CSF Certified status, ClarisHealth is distinguished as an organization that people can count on to keep their information safe,” said Ken Vander Wal, Chief Compliance Officer, HITRUST.

About ClarisHealth

ClarisHealth is the answer to the health plan industry’s siloed solutions and traditional models for identification and overpayment recovery services. We provide health plans and payers with total visibility into payment integrity operations through our advanced cost containment technology Pareo®. Pareo®enables health plans to maximize avoidance and recoveries at the most optimized cost for a 10x return on their software investment. 

Talk to ClarisHealth about how Pareo® can transform your health plan’s payment integrity operations.

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By Any Other Name: Sante Analytics Now Known as ClarisHealth

By Any Other Name: Sante Analytics Now Known as ClarisHealth

 Technology Company Focused on Total Payment Integrity for Health Plans, Providers and Third-Party Administrators

NASHVILLE, Tenn., Oct. 2, 2017 – Santé Analytics announced today that they will now be known as ClarisHealth. The change comes as they re-launch their innovative technology platform, Pareo™, to better serve their health plan, provider and third-party administrator clients.

ClarisHealth COO Jeff McNeese explains that in today’s complex healthcare market of expanding regulation and declining revenues, stakeholders are looking for innovative ways to grow and compete.

“When leadership says grow your department’s revenue by $20 million next year without adding any personnel, you need a truly transformative change and a partner that’s going to help you navigate those changes every step of the way,” says McNeese.

Payers, providers and third-party administrators have historically relied upon a saturated vendor market to optimize their revenue goals. Thanks to cutting-edge technology innovations, ClarisHealth is able to help payment integrity executives solve the challenges of audit and recovery with minimal negative impact on the organization.

“Being charged with doing more with less is nothing new for the market we serve,” McNeese continues. “But simply adding another vendor to the mix is not enough to measurably impact the bottom line.”

McNeese has the experience and data to back up his claims. ClarisHealth conducted surveys of two national health plans, four BC/BS plans and three regional plans examining payment integrity returns on claim spend. Results ranged from 1.2% to 7% return on claim spend. The key difference was the presence or absence of technology solutions that allowed for scale.

“Our clients are able to decrease medical expenses 3-5%, lower administrative costs 2-4%, and increase vendor efficiency 30%,” says ClarisHealth CTO Jim Weathersby. “That’s a ten-fold return on their investment in Pareo™.”

Health plan, provider and third-party administrator executives and department leaders are invited to see Pareo™ in action in a risk-free live demonstration. Sign up here for a convenient date and time.

About ClarisHealth

 Founded by leaders who were instrumental in the development of the cost containment industry, ClarisHealth was created to challenge the payer industry’s traditional models for identification and recovery services. Their technology platform, Pareo™, is a comprehensive solution that fosters visibility and transparency across the entire payment integrity ecosystem for all stakeholders, including third-party service providers, and also transforms credit balance operations for healthcare providers. Their Total Payment Integrity™ approach provides a unique combination of technology, services and expertise.