Want to maximize your health plan’s recoveries? Of course you do. Here’s how.
There’s a great deal of uncertainty in healthcare today, but one thing never changes: health plans’ desire to grow their recoveries. But, stuck dealing with insufficient technology or solutions that are siloed and not well connected, they can’t see the path to get there. We’ve written a lot of content about methods that health plans can use for growing recoveries, and summarized our findings below.
Download “Top 10 Ways to Maximize Your Health Plan’s Recoveries” infographic here.
What are the top 10 ways a health plan can maximize their recoveries?
Based on conversations with health plans across the nation, below is our roadmap to maximizing your recoveries. These ideas are likely familiar to you, even obvious. But, by leveraging the power of advanced payment integrity technology to put these solutions into play, health plans can grow their rate of recovery from an industry-average 1.2% to 7% or greater.
1. Simplify processes.
2. Add third-party vendors, stacked to greatest effectiveness.
Most health plans realize the benefits a third-party business partner brings to the table. The issue, however, is managing multiple vendors. With the right technology, health plans can easily onboard multiple third-party vendors and stack their focused expertise to optimize effectiveness.
“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.”
3. Minimize provider abrasion.
4. Fast-track concept innovation.
5. Integrate internal efforts.
6. Improve provider engagement.
Have you ever considered your net promoter score (NPS) — with your providers? How would they rank you to peers, and more pressingly, how does this affect your health plan’s ability to grow? Providers can become disengaged and disenchanted when processes (like medical records requests) are redundant or too vague. You can boost your provider NPS by focusing on improving the ways your health plan engages with health care professionals. For instance, Pareo® offers access to real-time data, allowing your plan to resolve questions with providers immediately.
“Health plans are increasingly interested in the Pareo® provider engagement module’s ability to streamline financial transaction management between payer and provider and significantly reduce friction inherent in traditional, paper-based methods.”
7. Expand internal capabilities.
8. Don’t overlook waste while looking for fraud and abuse.
9. Focus on prevention.
10. Embrace advanced technology.
Talk to ClarisHealth about how Pareo® can transform your health plan’s payment integrity operations.
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