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How to Build a Business Case for a Payment Integrity Platform
Everest Group Names ClarisHealth a Major Contender in Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026
Everest Group positions ClarisHealth as a Major Contender in Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026 industry report.
Why Payment Integrity Technology Is Harder to Buy Than a Payment Integrity Vendor
The challenge isn’t proving savings—it’s proving the value of a platform that improves everything else. That’s why making a business case for payment integrity platforms requires a fundamentally different conversation.
From Data Chaos to Operational Clarity: A Conversation with Emily Lemmon, Lead Software Engineer
This Q&A with Emily Lemmon is part of our Innovators series. Emily provides a behind-the-scenes look at the data and automation work that powers Pareo® — and explains why the greatest opportunities often come from rethinking processes, not just digitizing them.
Should Your Health Plan Build or Buy Payment Integrity Technology?
The real question isn’t whether you can build it. It’s whether building will help you scale faster, reduce administrative burden, and create a stronger foundation for payment integrity. Here’s how to decide.
Have You Hit a Wall Scaling Your Payment Integrity Operation?
As internal PI teams grow, vendor footprints expand, and savings targets rise, operational complexity can outpace control. Here’s how to recognize the tipping point — and what to do about it.
From Data to Decisions: A Conversation with Tom Baggett, Senior Director of Operations
This Q&A with Tom Baggett is part of our Innovators series. Tom reflects on payment integrity benchmarking, breaking down silos, and why the best insights don’t start with “aha” — they start with “no way.”
Report from the Field: Six Signals Reveal the Future of Payment Integrity
Payment integrity leaders from the country’s top health plans gathered at the Power of Payment Integrity Conference 2026. They found a community ready to take on today’s challenges and create tomorrow’s solutions.
ClarisHealth Appoints Michael Axt as Chief Executive Officer
ClarisHealth is evolving its leadership team to advance payment integrity innovation with the appointment of new CEO Michael Axt. Longtime CEO Jeff McNeese will transition to President, Market Innovation & Strategic Partnerships.
ClarisHealth Benchmarking Report Shows 37% of Payment Integrity Savings Driven by Top Five Concept Categories
New benchmarking data highlights how a focused set of payment integrity concepts drives disproportionate value across health plans.
ClarisHealth Earns Spot on Inc. 2026 Fastest-Growing Companies List as Health Plans Shift to End-to-End Payment Integrity Platforms
Fourth consecutive ranking on Inc Regionals list for ClarisHealth reflects growing demand for Pareo®, the only payment integrity platform that closes the loop across the audit lifecycle to reduce administrative costs and improve financial outcomes for health plans.
AI in Payment Integrity: Why the Foundation Matters More Than the Algorithm
Payment integrity leaders are operating in one of the most challenging payer environments in over a decade. Those realizing the largest returns from AI are using best practices, which include ensuring AI is part of a broader closed loop system vs. used as a point solution.
People First, Always: A Conversation with Tara Dufrene, VP of Client Engagement
This Q&A with Tara Dufrene is part of our Innovators series. Tara reflects on a decades-long career helping payment integrity leaders turn strategy, technology, and trust into real results.
Engineering the Future of Payment Integrity: A Conversation with Alex Yanes, VP of Engineering
This Q&A with Alex Yanes is part of our Innovators series. Alex explains how empathy, security, and product thinking guide the technology powering modern payment integrity for health plans.
2026 Payment Integrity Technology Trends: The Shift From Savings Engine to Enterprise Control
What is on the horizon for healthcare payer technology in 2026? In this annual report, ClarisHealth and industry experts review the trending drivers – and associated opportunities – so health plans can innovate payment integrity while minimizing risk.
From Manual Muscle Memory to Modern Payment Integrity: A Conversation with Dana Ryan, Senior Manager Client Success
This Q&A with Dana Ryan is part of our Innovators series. Dana shares lessons learned from 20+ years helping health plans unlearn old processes, embrace automation, and see ROI from their PI programs.
Consistency Is the New Scalability: A Conversation with Stephanie Gibbons, Vice President Clinical Operations and Internal Audit Management
This Q&A with Steph Gibbons is part of our Innovators series. Steph breaks down the core principles driving her approach to transforming health plan operations including clinical nuance, operational discipline, and a deep respect for the work.
Health Plans Need a Tech-First Strategy to Navigate Today’s Consolidation Pressures
How payment integrity leaders can strengthen their plan—whether the goal is to attract the right partner or remain confidently independent.
Bridging Product, Data, and Operations: A Conversation with Chandler Wilson, Senior Product Owner
This Q&A with Chandler Wilson is part of our Innovators series. Her 15-years’ experience in payment integrity and healthcare technology brings insights into how aligning systems, people, and strategy in Pareo® helps health plans turn data complexity into operational clarity.
A Lifelong Advocate for Health Plans: A Conversation with Kimberly Fadden, SVP of Client Management
This Q&A with Kimberly Fadden, a 40-year healthcare technology leader, covers payment integrity, client advocacy, and navigating cost pressures with trust and transparency as part of our Innovators series.
ClarisHealth Named a Top 10 Payment Integrity Market Innovator, According to Everest Group
Everest Group spotlights ClarisHealth among “high potential” innovators with technology-first solutions disrupting traditional payment integrity models in “Reshaping Payment Integrity Solutions: Specialists Creating Buzz in the Market” industry report.
Beyond Disruption: 5 Strategies Every Health Plan Needs for 2026
When industry disruption is constant, your strategy needs flexibility. Here’s what successful payment integrity leaders are doing now to prepare for 2026 and beyond.
Behind the Data: A Conversation with Quzonna Reed, Business Systems Analyst
This Q&A with Quzonna Reed, who has worked with ClarisHealth for over six years helping health plans transform their data to power smarter payment integrity with Pareo®, is part of our Innovators series.
Registration Opens for the Only All-Payment Integrity Conference: POP 2026
Health plan leaders set to return to Nashville April 14–16, 2026 for three days of peer-led strategy, collaboration, and networking at ClarisHealth’s Power of Payment Integrity Conference.
Driving the Future of Payment Integrity: A Conversation with Tom Noack, SVP of Product Strategy
This Q&A with Tom Noack, who has deep roots in the community from years of hands-on experience leading PI teams at a top 10 payer – where he was instrumental in bringing on Pareo®is part of our Innovators series.
ClarisHealth Ranks on the Inc. 5000 for the 6th Year in a Row
ClarisHealth, provider of the industry’s only integrated payment integrity technology for health plans, in elite group of consecutive-year honorees on the 2025 Inc. 5000 list of America’s fastest growing private companies
Power of Payment Integrity Conference Reveals 5 Strategic Insights
Payment integrity leaders from the country’s top health plans came together for the Power of Payment Integrity Conference. They found strength in community, innovative ideas, and 5 powerful themes that will drive progress in the industry.
ClarisHealth Hires Health Plan Veteran Tom Noack to Lead Product Team
Newly appointed senior vice president of product strategy will support strategy and growth of Pareo® integrated platform for payment integrity operations.
ClarisHealth Reveals Key Operational Performance Benchmarks for Payment Integrity Programs
Payment integrity program performance benchmarks showcased at inaugural Power of Payment Integrity Conference gathering of leaders from 35 health plans
ClarisHealth Named to Inc. 2025 List of the Fastest-Growing Private Companies in the Southeast for the Third Time
ClarisHealth, the only provider of an integrated payment integrity operations platform, today revealed it ranked on Inc.’s fifth annual Inc. Regionals: Southeast list. This year marks the third time ClarisHealth has been named to the prestigious ranking of the fastest-growing private companies in the Southeast. Continued hypergrowth attributed to increasing adoption of Pareo®, the industry’s only integrated payment integrity operations platform for health plans.
Research Proves Pareo® Payment Integrity Platform Yields Over 3x ROI for Health Plans
ClarisHealth worked with Hobson & Company to independently validate nine sources of value realized by health plans leveraging Pareo®. Findings published in white paper and self-serve ROI calculator.
ClarisHealth Reinforces Position as Payment Integrity Technology Innovator for Health Plans with a Banner 2024
ClarisHealth accelerates strategic growth into 2025 with thought leadership and expansion of Pareo® technology ecosystem. In another year of increasing complexity for healthcare, benchmarks across team expansion, technology innovation, and industry recognition achieved in 2024 demonstrate growing momentum in favor of ClarisHealth’s approach that offers health plans a better way to decrease payment integrity administrative costs while improving medical savings.
ClarisHealth Hires Ron Kozlin as New Chief Financial Officer
Technology industry veteran joins executive team to lead financial strategy supporting growth of Pareo®, the only integrated payment integrity operating system for health plans. In this chief financial officer role Kozlin will oversee enterprise-wide optimization of ClarisHealth’s financial operations.
Buying payment integrity technology: 6 considerations
More health plans see the value in reducing administrative complexity to improve costs and payment accuracy. This step-by-step guide for payment integrity leaders buying enterprise technology ensures you reach those goals.
ClarisHealth Partners with Expion Health to Offer Enhanced Out of Network Claims Management Services on the Pareo® Platform
ClarisHealth, provider of the leading integrated payment integrity technology platform for health plans, announced a strategic partnership with Expion Health. ClarisHealth is pre-integrating Expion Health into the Pareo® platform to offer enhanced out of network (OON) claims management capabilities designed to detect and avoid more claims overpayments without additional IT costs.
ClarisHealth Opens Registration for the Only Peer-Led Payment Integrity Conference
Power of Payment Integrity, the industry’s only all-payment integrity, no-sales pressure conference, returns to Nashville, Tenn., April 21-23, 2025. The two-day educational event is free for health plans to attend.
ClarisHealth Makes the Inc. 5000 5 Years in a Row
ClarisHealth, provider of the industry’s only integrated payment integrity technology platform for health plans in elite group of consecutive-year honorees on the Inc. 5000.
Payment Integrity Leaders Reveal What Will Move the Industry Forward
Payment integrity leaders from the country’s top health plans take time to collaborate at POP Conference 2024. They find strength in community, innovative ideas, and a focus on 4 primary industry drivers.
ClarisHealth Awarded on the Financial Times Americas’ Fastest Growing Companies 2024 List for the Second Time
ClarisHealth, provider of the industry’s only integrated payment integrity technology platform, awarded on the Financial Times Americas’ Fastest Growing Companies 2024 List for the second time.
ClarisHealth Hires Nick Ridings as SVP of Health Plan Relationships
ClarisHealth, provider of the industry’s only integrated payment integrity technology platform, hires Nick Ridings as SVP of Health Plan Relationships to scale adoption of Pareo. Ridings is an alumnus of AIM Healthcare and Optum.
ClarisHealth Unveils New Brand to Complement Revitalized Mission
ClarisHealth, provider of the industry’s only integrated payment integrity technology platform, connects company’s modernized look to the continued evolution of the health plan market and their desire for advanced technology.
Improving Payment Integrity with a Building Blocks Methodology
Payers need a proven framework for payment integrity to create financial value, handle change, and engage at the highest levels of organizational strategy. This 5-step methodology works whether the directive is accelerating growth, building from scratch, or somewhere in between.
ClarisHealth Highest-Designated Major Contender in Everest Group Payment Integrity Solutions PEAK Matrix® Assessment 2024
Leading provider of enterprise payment integrity technology for health plans included in industry analysis report. Position credited to its unique adaptability to address payer pain points at multiple stages of their payment integrity journey.
ClarisHealth Secures Significant Growth Investment from Pamlico Capital to Accelerate Market Position with Health Plans
Leading provider of enterprise payment integrity technology for health plans partners with experienced private equity firm for minority growth round. Investment will expand the scale of operations, product innovation, and further the company’s mission to create a better way to drive claims payment accuracy.
ClarisHealth Hires Gary Eeds as Chief Operating Officer
Healthcare technology delivery veteran joins senior leadership team to scale adoption of enterprise payment integrity platform for health plans. As Chief Operating Officer, Eeds is excited to join ClarisHealth to continue the mission of removing administrative friction from healthcare.
ClarisHealth Makes the Inc. 5000 4 Years in a Row
ClarisHealth, provider of the industry-leading payment integrity technology platform Pareo®, today announced it ranked for the fourth year in a row on the Inc. 5000. ClarisHealth attributes its sustained revenue hyper-growth rate to health plans aggressively adopting Pareo to support digital transformation of their payment integrity operations.
Will Artificial Intelligence Finally Make Good on its Promise to Healthcare?
Artificial Intelligence is making the leap from much-hyped “trend” for healthcare technology to more widespread adoption. Here’s what A.I. is — and isn’t — and how health plans are proving its value. Artificial Intelligence for healthcare has come a long way since...
Payers Reduce Administrative Costs by Going Back to Basics with Payment Integrity
In the face of economic and hiring constraints, payment integrity leaders are prioritizing these 4 best practices to shift to an enterprise strategy that offers proven value.
Health Plan Leaders Speak Out on Building the Payment Integrity Organization of Tomorrow
Whether or not health plan leaders implement a fully centralized PIO, sharing information on an enterprise payment integrity technology platform helps overcome challenges and meet strategic opportunity.
ClarisHealth Ranks on Inc. 5000: Regionals Southeast List for the 2nd Year in a Row
ClarisHealth, provider of the industry-leading payment integrity technology platform Pareo®, today announced it ranked for the second year in a row on the third annual Inc. 5000 Regionals: Southeast list, the most prestigious ranking of the fastest-growing Southeast private companies, based in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, Puerto Rico, South Carolina, and Tennessee. ClarisHealth attributes its sustained revenue hyper-growth rate to an industry shift toward innovation.
Study Reveals Payers Recover Overpayments 50% Faster with Enterprise Technology
In an industry that has struggled to quickly and meaningfully address healthcare claims payment accuracy, digital transformation once again proves its value. How can payers best take advantage of the potential of enterprise technology?
How Medicaid Managed Care Organizations Are Faring on Top 3 Issues
What can your Medicaid MCO do to prepare for this year and beyond? Medicaid managed care organizations are continually in a balancing act, facing tighter-than-average budgets, political pressures, and an evolving, uncertain healthcare landscape. The COVID-19 public...
For the 2nd Year, ClarisHealth Ranks on the 2022 Deloitte Technology Fast 500
ClarisHealth, provider of the industry-leading payment integrity technology platform Pareo®, today announced it ranked No. 485 on the Deloitte Technology Fast 500™, a ranking of the 500 fastest-growing technology, media, telecommunications, life sciences, fintech, and energy tech companies in North America, now in its 28th year. ClarisHealth attributes 248% revenue growth to the increased strategic importance of enterprise technology for health plans.
Pareo Clients Improve Payment Accuracy Results in Just One Year, ClarisHealth Study Finds
Pareo®, the industry’s leading payment integrity platform for health plans, reveals efficiencies and improved claims overpayment identifications and recoveries year-over-year, according to an internal study conducted by ClarisHealth business insights analysts. The study shows that Pareo clients recover overpayments 50-percent faster, increase recoveries 31-percent, and increase identifications 21-percent after the first year of platform adoption.
ClarisHealth Hires Tate McDaniel as Chief Revenue Officer
ClarisHealth, provider of industry-leading payment integrity technology for health plans, today announced that Tate McDaniel joined the company’s senior leadership team as chief revenue officer. McDaniel will lead the company’s integrated growth team to scale adoption of ClarisHealth’s enterprise payment integrity technology Pareo® in the payer market.
ClarisHealth Achieves HITRUST Risk-based, 2-year Certification to Further Mitigate Risk in Third-Party Privacy, Security and Compliance
ClarisHealth, provider of industry-leading payment integrity technology for health plans, today announced the Pareo® platform has earned Certified status for information security by HITRUST. HITRUST Risk-based, 2-year (r2) Certified status demonstrates that the organization’s Pareo technology platform has met key regulations and industry-defined requirements and is appropriately managing risk.
For the 3rd Time, ClarisHealth Appears on Inc. 5000, Ranking No. 2362
Today, Inc. revealed that ClarisHealth, provider of the industry’s leading payment integrity platform for health plans, is No. 2362 on the 2022 Inc. 5000 list. This is the third year running that the company has ranked on the list.
ClarisHealth Awarded No. 251 on Financial Times’ List of Fastest Growing Companies in the Americas 2022
ClarisHealth, leading provider of payment integrity technology for health plans, today announced it is No. 251 on the Financial Times’ list of the fastest growing companies in the Americas for 2022.
ClarisHealth Ranks No. 51 on Inc. Magazine’s List of the Southeast Region’s Fastest-Growing Private Companies With Two-Year Revenue Growth of 260-Percent
ClarisHealth, leading provider of payment integrity technology for health plans, today announced it is No. 51 on Inc. magazine’s third annual Inc. 5000 Regionals Southeast list. ClarisHealth is the fastest growing private company in Tennessee on the list.
ClarisHealth Honored in Forbes as One of America’s Best Startup Employers 2022
ClarisHealth, leading provider of payment integrity technology for health plans, today announced it has been awarded a spot on the Forbes list of America’s Best Startup Employers 2022 for the second year in a row. This prestigious award is presented by Forbes and Statista Inc. and recognizes the top 500 companies based on over 8 million data points evaluating employer excellence.
ClarisHealth Ranks No. 8 on List of Largest Healthcare IT Companies in Nashville
ClarisHealth, leading provider of payment integrity technology for health plans, today announced it ranked No. 8 on the list of Largest Healthcare IT Companies in Nashville.
ClarisHealth Ranked No. 462 Fastest-Growing Company in North America on the 2021 Deloitte Technology Fast 500
ClarisHealth, leading provider of payment integrity technology for health plans, today announced it ranked No. 462 on the Deloitte Technology Fast 500™, a ranking of the 500 fastest-growing technology, media, telecommunications, life sciences, fintech, and energy tech companies in North America, now in its 27th year.
Payment Integrity Leaders Ready For A New Normal
With the ever-changing outlook of the payment integrity industry, now is the time to get ahead by making strategic investments in change.
ClarisHealth Named a Preferred Vendor by the Association for Community Affiliated Plans
ClarisHealth named a preferred vendor by the Association for Community Affiliated Plans, provides unique payment integrity and FWA technology platform for ACAP member Safety Net Health Plan digital transformation goals.
ClarisHealth Recognized By Gartner For Prospective Payment Integrity
ClarisHealth Recognized as Sample Vendor Offering Prospective Payment Integrity Solutions in Gartner® Hype Cycle™ for U.S. Healthcare Payers, 2021.
For The 2nd Time, ClarisHealth Appears on the Inc. 5000, Ranking No. 1941 With Three-Year Revenue Growth of 230-Percent
Inc. magazine today revealed that ClarisHealth, leading provider of payment integrity technology for health plans, is No. 1941 on its annual Inc. 5000 list.
A Better Way to Conduct Medical Claims Audits
With advanced technology, health plans can take control of their medical claims audits while achieving high ROI. Here’s how.
ClarisHealth a Winner of NBJ 2021 Best in Business Awards
Leading provider of technology platform for health plans one of 8 honorees selected for annual Nashville business award. ClarisHealth is honored to be declared a winner of the 2021 Nashville Business Journal (NBJ) Best in Business Awards. For over 30 years, the NBJ...
Vendor Consolidation Reduces Payment Integrity Innovation
What steps should your health plan take to ensure you get the most value from your services vendors and payment integrity efforts in the face of vendor consolidation?
Strategies to Move Your Payment Integrity Program Prospective
Payment integrity evolves into a more strategic function for health plans in order to reduce overall healthcare expense. Prepay drives greater cost savings but can be difficult to achieve. Here, we share strategies that can enable prospective cost avoidance programs...
Are You Hurting Provider NPS with Your Payment Integrity Efforts?
Look out for these 4 elements of payment integrity that may negatively impact provider NPS (net promoter scores) with your network providers. The Net Promoter Score (NPS) – an established metric traditionally managed by insights and marketing departments – can drive...
The Strategic Approach to Claims Cost Containment
Competing with other health plan functions for technology priority can lead to missed audit claims cost savings potential. An integrated payment integrity strategy breaks down these internal silos. With so many moving – and vital – parts within a payer organization,...
How to Evaluate Payment Integrity Solutions: The Ultimate Guide for Health Plans
Payment integrity solutions vendors make many claims. Here are the top 11 areas of evaluation to ensure a perfect fit for your health plan. Virtually every health plan is looking to address shrinking margins by moving their medical savings from a typical 1-2% today to...
5 Steps to Reducing Waste and Abuse
Use these tech-enabled tips to comprehensively reduce FWA. States require MCOs to take proactive measures that reduce not just fraud, but also waste and abuse. But how can you ensure your efforts not only meet compliance requirements but also help secure a competitive...
Your 5 Point Clinical Audit Checklist to Reduce Provider Abrasion
In part 2 of our series we outline exactly what health plans should look for in an advanced technology platform for clinical audit Paying claims right the first time – while making the most of internal resources – is the primary goal at most payer...
ClarisHealth on the Breaking Health Podcast
Listen to this conversation about building the right team and technology to help health plans tackle their entire payment integrity continuum. ClarisHealth CEO Jeff McNeese sat down with Steve Krupa, CEO of Healthedge and contributing host at Healthegy, for the latest...
The Strategy Nearly Every Health Plan Considers: Outsource vs. Insource
Slim margins, fewer resources, and consolidation have made it harder for health plans to compete. Could balancing outsource vs insource efforts accelerate their goals? With shrinking margins, fewer and fewer internal experts, and increasing consolidation, health plans...
ClarisHealth Ranks No. 8 Among Tennessee Software Companies on the 2020 Inc. 5000
ClarisHealth Ranks No. 8 Among Tennessee Software Companies on the 2020 Inc. 5000 NEW YORK and NASHVILLE, Tenn., August 13, 2020 – Inc. magazine today revealed that ClarisHealth is No. 8 among Tennessee software companies on its annual Inc. 5000 list, the most...
6 Steps to a Successful Prepay Strategy
Health plans can take control of their own prospective provider audits instead of over-relying on services vendors with the help of advanced technology and access to proven analytics. We’ve written before about why it’s important for health plans to start thinking...
5 Reasons for Health Plans to Choose a Scalable Payment Integrity Technology Platform
Are you using an assortment of software tools to do work better suited to a platform? You might be missing out. When your health plan starts looking to upgrade your payment integrity and fraud management processes with technology, what do you turn to? A tool or a...
Healthcare Interoperability Poised to Solve COVID-19’s Big Data Crisis
Coronavirus highlights power of big data and the need for interoperability to improve population health. How can health plans lead the way? What’s the single biggest weapon used by government, pharma, academic researchers, healthcare systems, and health insurers alike...
Your health plan’s best crisis response strategy? Innovation.
Health plans set themselves up for success – during a pandemic and beyond – by pursuing advanced technology to engage providers, satisfy members, and improve population health initiatives. The healthcare system is on the front lines of the novel Coronavirus pandemic,...
Try Before You Buy: A bottom-up approach to health plan technology adoption
Why flipping the script enterprise software is the future of digital transformation? Have you ever tried a piece of technology at your health plan before it was adopted by the broader organization? Think about solutions like MailChimp, Survey Monkey, Slack and...
Diving Deeper into Healthcare Claims Audits: Part 1 – Auditor Workflow
The first installment in a multi-part series aimed at clinical auditors. Part 1 takes a closer look at 5 trends impacting how health plans manage claims auditing today. Claims auditing. It’s the core function of any health plan payment integrity operation. Ensuring...
Should Your Health Plan Build or Buy a Technology Solution? OLD
As payment integrity leaders weigh custom vs. configurable, best practices vs. home-grown it's important to keep in mind: flexible solutions offer greater value to health plans. Whether your health plan has decided it has outgrown its manual paper-based processes or...
Data Privacy Concerns Meet Digital Progress
Data privacy and security will always be top of mind for health plans in an environment where access to data is crucial to growth. Here are some safeguards for payers. How do payers balance their need for broader access to data with their need to improve trust with...
Two Healthcare Technology Veterans Join ClarisHealth’s Board
Doug Ghertner and George Lazenby, IV, add significant expertise to the healthcare payer technology company’s board of directors NASHVILLE, Tenn., Jan. 30, 2020 – ClarisHealth, the company transforming health plan operations with its comprehensive payment integrity...
ClarisHealth Hires Mark Lavallee as Chief Growth Officer
Industry veteran will extend ClarisHealth’s strategic direction in accelerating adoption of market-leading technology solutions for health plans. NASHVILLE, Tenn., Jan. 20, 2020 – ClarisHealth, the company transforming health plan operations with its comprehensive...
Top 10 Reasons Health Plans Choose Pareo
It’s almost 2020, and forward-thinking health plans have a choice when it comes to total payment integrity solutions. From smaller regional plans with 100k members to large national health plans with millions of lives covered, Pareo scales to accommodate all needs....
Where does your health plan reside on the payment integrity continuum?
Take this interactive self-assessment to determine how much progress your health plan has made towards modern digital transformation. The goal for every future-looking health plan is to transition payment integrity efforts from predominantly external post-pay, to a...
Behind the Curtain: What to expect when you implement Pareo
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...
Why we focus on the problem, not the health care solution
ClarisHealth CEO Jeff McNeese shares how our tech company created a solution born directly out of the frustrations with the healthcare industry, by experienced healthcare workers. A major health plan client came to us recently and asked “Can you partner with us on...
Here’s What You Don’t Know about Fraud, Waste and Abuse
Fraud is different from Waste and Abuse, and most technology solutions don’t adequately address either issue. Think you know how to manage fraud, waste and abuse at your healthcare organization? CMS doesn’t agree. In fact, the promises of change and reform coming from...
Managing Medical Record Requests a problem? We’ve got the solution.
How to manage medical record retrieval processes with multiple clinical audit vendors to increase payment integrity savings, not provider abrasion.
Be the change agent you wish to see at your health plan
8 essential skills every change agent needs to navigate the future of healthcare Whether you’re already leading change at your organization or hoping to do so soon, most health plan employees need to be well versed in change management as the industry braces for rapid...
Communication Makes Digital Transformation Work
What happens after you choose a payment integrity solution? Learn how communication factors into successful digital transformation.Chances are, your health plan is undergoing some type of digital transformation this year, and you’re not alone. A recent survey of...
Quiz: Should You Build Your Own Supplier Management Solution?
Take our quiz to help you decide if build or buy is right for your health plan. By now, you likely realize that your health plan needs a way to manage the many third-party vendors that allow you to maximize recoveries and optimize costs. The question is, should you...
Creating a Community of Users
When you adopt Pareo®, you gain access to a large community of health plan professionals offering shared expertise. From time to time, we like to remind our readers that “you don’t have to go it alone.” That isn’t just an empty catchphrase we use to market to new...
Lack of Documentation is a $23 Billion Overpayment Problem for Medicare
Medicare overpayment is a massive problem, and lack of documentation is a significant contributor. When we see errors adding up to billions of dollars in improper payments, we pay attention. As payment integrity technology experts and also healthcare consumers we take...
The Value of Collaboration: Find Your Power
Collaborative organizations — no matter the industry — are proven to be more effective. How can you tap into this mojo? Your health plan has working relationships with members of other departments, third-party payment integrity service suppliers and providers. By...