Health Plans Ready for the
Future of Payment Integrity

In the daily shuffle of inefficient systems and managing post-pay inventory, have you lost your focus on overpayment prevention? How about your ability to manage relationships with other departments, providers and business partners? Your health plan isn’t alone in these challenges.

If budget, time and expertise were no object, you could build the perfect custom technology solution for your health plan.


What’s on your wish list?

  • Data analytics and predictive modeling to score claims for overpayment risk
  • Reporting to identify root causes
  • Tools to manage tight deadlines
  • Platform to integrate fragmented data sources
  • Secure access for all stakeholders to support seamless communication and foster engagement

The innovative payment integrity platform Pareo® is just the solution your health plan has been working towards.

“The typical healthcare payer’s internal IT systems and processes … are plagued with disparate information systems, fragmented member information, legacy IT burdens, insufficient transparency in financial records, and inflexible, manual processes. The need of the hour in this regard is systems integration, data standardization and homogenized processes.”

Everest Group

“Healthcare Payer Annual Report: Payers Look at Digital to Reinvent in a Turbulent Healthcare Market”

Break Down Data Silos


Healthcare analytics rely on rules and statistics that assume the data will be well-structured, singularly accessible and accurate. But, claims data can be up to 70% inaccurate, most supporting information lives in inaccessible systems, and 50% of clinically relevant data isn’t formatted for ready analysis.

Imagine a world where your health plan can control all cost-containment efforts through one integrated platform, rather than unwieldy spreadsheets and status emails. Pareo® payment integrity technology provides that control through unparalleled visibility.


  • Bring together disparate data sources
  • Manage third-party payment integrity vendors
  • Streamline medical records requests
  • Improve visibility into workflow and processes
  • Reduce provider abrasion

Improve Provider Relationships


Your health plan’s efforts around cost containment are the source of 90% of the friction with your network of providers. What’s more, that friction may be undermining your best efforts to improve member satisfaction.

Pareo® provides a solution to improve provider engagement with your health plan, through improved payment integrity processes. Payers and providers reduce costs while opening up the lines of communication. Your providers will agree; it’s a win-win.


  • Pay claims right the first time
  • Reduce false positives
  • Streamline clinical documentation requests

Maximize Third-Party Vendor Partnerships


What could your health plan do with more payment integrity vendors, stacked to everyone’s best advantage, integrated into your processes and onboarded with little to no additional administrative burden? Your payment integrity operations would really take off.

Concerns about the costs and management of third-party vendor relationships hold too many health plans back from enjoying the specialized expertise and increased efficiency these business partnerships can bring. Pareo® brings peace of mind to health plans so you no longer have to guess at the value of your your payment integrity vendors.


  • Expand your third-party vendor program
  • Minimize administrative lift
  • Fast-track new concepts
  • Ensure appropriate claim assignments
  • Real-time communication and recovery tracking

Industry Perspectives

Every week, our payment integrity and FWA experts analyze industry trends and opportunities to bring fresh perspectives to you. Here’s the latest:

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.

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

In this on-demand webinar, Kurt Spear of Highmark Blue Cross Blue Shield demonstrates how they adopted and continue to scale their use of Pareo to realize their vision for improved efficiency, effectiveness and innovation across ...

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

Season 1: Bonus Episode - How has Highmark Blue Cross Blue Shield achieved an industry-leading 27:1 ROI on their payment accuracy and FWA operations? Listen as Kurt Spear, VP Financial Investigation and Provider Review for Highmark, ...