Payment integrity vendors are critical to the success of any health plan. As health plans realize this, they are working to create stronger partnerships. Here’s how Pareo® helps.
We were talking to a health plan recently about our comprehensive payment integrity technology Pareo® and its robust vendor management capabilities. They were impressed with the oversight and concept validation possibilities but worried about one thing: “How are my vendors going to take this?”
The right technology can foster a more collaborative, productive relationship between your health plan and your best vendors. Pareo helps health plans maximize their vendors so that maximum recoveries can be made while also easing provider abrasion.
More vendors equal greater returns for health plans.
It doesn’t cost as much these days to onboard a vendor, which works to a health plan’s advantage. More vendors equal more experts working on behalf of healthcare payers to improve recoveries and payment integrity. We encourage clients to bring on as many vendors as they want, and Pareo supports that effort.
A vibrant partnership is rooted in transparency.
Our implementation team works to securely integrate third-party vendors and answer any questions that they may have. Pareo makes onboarding new vendors much easier for health plans, and greatly streamlines the vendor effort needed to receive claim files, submit audits, and get real-time feedback on denials.
Pareo® gives health plans vendor transparency.
A vibrant partnership is rooted in transparency. Our technology platform Pareo assists in vendor partner development that encourages clear communication and fosters quicker adoption of new concepts. Our clients are able to strategically stack and segment high-performing vendors because of the clarity our platform provides. Furthermore, clients can mutually develop goals with vendors and track performance real-time. This open communication allows health plans and their vendors to mitigate any complications as they arise, instead of allowing issues to compound.
Integration with Pareo gives vendors insight into health plan data. This information is an opportunity for health plans and their vendors to streamline processes and focus efforts. One such opportunity is Pareo’s capability to provide clear health claim assignments and parameters, which avoids double work from vendors and allows them instead to work only on claims that they will be reimbursed for.
Access advanced technology through our platform.
Health plans and their vendors benefit from advanced technology. Pareo utilizes advanced analytics and AI to create opportunity and close the gaps that traditional fraud, waste and abuse technology leaves behind. Pareo’s automation tools mean that vendor audits are running through a series of software-enabled overlap checks prior to a health plan review.
“Data management doesn’t sound like a sexy value proposition, but it ends up being of incredible value. So really, if an organization is able to cleanse and aggregate data from multiple sources and bring the data into its analytics, you get better results,” says Chris Jaeger, M.D., vice president of accountable care innovation and clinical transformation at the San Francisco-based Blue Shield of California. As one example of how Pareo®’s data management capabilities yield greater results, the platform streamlines medical record requests, significantly reducing provider abrasion.
ClarisHealth: Working collaboratively with health plans and vendors for total payment integrity.
ClarisHealth’s mission is to transform engagement in healthcare. Through our comprehensive payment integrity platform Pareo®, we are bringing health plans and vendors together to create meaningful and profitable long-term partnerships.
Now’s the time for total payment integrity
See the ClarisHealth 360-degree solution for total payment integrity in action.