NASHVILLE, Tenn., Oct. 7, 2021 – ClarisHealth, the company transforming health plan operations with its comprehensive payment integrity technology platform Pareo®, announced today they have been designated as a Preferred Vendor by the Association for Community Affiliated Plans (ACAP).
ACAP is a national trade association which represents not-for-profit Safety Net Health Plans, collectively serving more than 20 million people in Medicaid, Medicare, Affordable Care Act Marketplaces and other publicly supported programs. Preferred Vendors must go through a rigorous review process to be approved into the program.
ACAP’s goal to “strengthen members strategically and operationally to improve their quality, efficiency, competitiveness and sustainability…” is well-aligned with the capabilities offered by Pareo. ClarisHealth counts several ACAP-member health plans as Pareo clients that use the platform to support cost containment and digital transformation strategies.
“We are honored to be named a Preferred Vendor by ACAP,” says Mark Lavallee, Chief Growth Officer at ClarisHealth. “Since ClarisHealth’s beginnings in 2013, we have worked with Safety Net Health Plans to develop technology-enabled payment integrity and FWA solutions. These claims cost-savings innovations ensure they have more funds available to serve their members and communities. It is a privilege to expand upon this mission by supporting ACAP-member plans.”
ClarisHealth’s integrated technology platform Pareo is a HITRUST CSF® Certified SaaS solution for payers that enables them to manage external and internal cost-containment operations at a greater ROI than traditional market solutions. One ACAP-member health plan client doubled their overpayment recoveries after only their first year of using Pareo and has realized a 15x return on their software investment.
Pareo can meet many use cases across a health plan, with feature sets that can be stacked to build configurable solutions and multi-year strategies:
Vendor management: Optimize outsourced payment integrity operations with integrated workflows and increased visibility to improve services supplier efficiency by 35%.
Audit internalization: Enable internal auditors, nurses, coders and analysts to efficiently conduct data mining, DRG and IBR audits with automated workflows and A.I.-powered detection that improves analyst productivity 3x.
Prospective cost avoidance: Reduce improper payments with full visibility into overpayment recovery operations, automation, root cause remediation, and ability to shift detection analytics to prepay to improve cost avoidance by 35%.
Fraud, waste and abuse mitigation: Harness A.I.-powered provider detection models to go deeper and wider into data to surface real-time anomalies and manage cases while seamlessly coordinating with payment integrity to improve efficiency and effectiveness for a 20-50% increase in savings.
ClarisHealth looks forward to partnering with additional ACAP-member plans to help them maximize claims cost avoidance and recoveries at the most optimized cost. For more information on the Pareo technology platform, please visit https://www.clarishealth.com/solutions/.
ACAP represents 78 health plans, which collectively provide health coverage to more than 20 million people. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other publicly-sponsored health programs. For more information, visit www.communityplans.net.
ClarisHealth, an Inc. 5000 company and recognized as a “major contender” in payment integrity by Everest Group, is the answer to the health plan industry’s siloed solutions and traditional models for identification and overpayment recovery services. ClarisHealth provides health plans and payers with total visibility into payment integrity operations through its proprietary, A.I.-powered cost containment technology platform Pareo®. Pareo enables health plans to maximize cost avoidance and recoveries at the most optimized cost for a 10x return on their software investment. For more information, please visit www.clarishealth.com.