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.
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Vendor Relationships
Have You Hit a Wall Scaling Your Payment Integrity Operation?
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.
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.
Reimagining Payment Integrity: How Health Plans Can Optimize Using a Modern Operating System Built for the Future
Are payment integrity strategies stuck in the past? This strategic brief explores 4 concepts health plans can use to update business models and optimize using a modern operating system built for the future.
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.
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.
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?
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...
An Aggressive Plan to Move your Claims Recovery to Prepay Status
Transitioning more payment integrity operations to internal prepay is more than just a pipe dream for health plans Transitioning prepay. It’s the holy grail for health plans — and viewed as equally unattainable. And, in the not-so-distant past, this viewpoint would...
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.
Checking in: How to offer vendors a concierge experience
When we created Pareo®, from its inception we knew vendors would be an important stakeholder in the payment integrity ecosystem. As our payment integrity solution has grown (in many ways, shaped by our incredible clients), it has cemented our belief that focusing on...
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...
Top 10 Ways to Maximize Your Health Plan’s Savings
Want to maximize your health plan’s savings? 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 savings. But, stuck dealing with insufficient technology or...
Thoughts on Creating a Centralized Payment Integrity Department
Does it make sense for your health plan to carve out Payment Integrity from your other cost containment efforts into a dedicated department with greater oversight capabilities? Historically, payment integrity efforts have been scattered among specialty departments...
5 Ways Pareo® Benefits Health Plan Vendors
ClarisHealth’s Total Payment Integrity™ solution strengthens vendor partnerships Sooner or later it’s bound to happen: your health plan wants to shake things up a bit. New processes, new technology, new point of contact, bringing new third-party services providers on...
How to Maximize Vendor Partnerships with Pareo®
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...
Stop Spinning Your Wheels
How to get your health plan out of a rut and break down big data silos. Health plans are tasked with deriving ever-more savings from their claims overpayment initiatives. But with limited people, strategy, technology or processes to accomplish their goals, are they...
Grow Your Payment Integrity Efforts with Outsourced Vendor Management
An ideal vendor solution for growing PI departments Building and running a payment integrity department isn’t easy – or inexpensive. There will likely be hurdles along the way, and it isn’t as if the rules around improper payments and claims management are standing...
Health Plan Vendors Don’t Have to Be a Hassle … If They’re Well Managed
Gain the oversight you need to manage your health plan’s third-party services providers. Recently, a client shared with us that the IT cost to bring on a health plan vendor was $70k. That stopped us in our tracks. $70k is, in our opinion, way too much for a health...
Maximize Value & Partnership with Your Third-Party Payment Integrity Vendors
Ask yourself these 6 questions to get the most from your payment integrity vendors. Looking to get the most out of your third-party payment integrity solution vendors? Consider asking yourself the following questions to determine if your vendors are providing you with...