Opportunity Identification & Tracking

Controls what gets audited, by whom, and why — enforced at submission.

Every audit tied to an approved concept — no valid project code means automatic rejection. 

How It Works:

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Vendor submits concept for payer review & approval
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Project code assigned — all audits must reference it
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Performance data drives internalization decisions

Pareo Delivers Value

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Vendor compliance enforced by the system

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Increase in total overpayments identified

%

Reduction in claims write-offs

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Increase in overpayment recoveries

Key Functions Powering Opportunity Identification & Tracking

Concept Management

Repository for audit concepts with rationale, expected savings, target population, and approval status.

Concept File Exchange

Bulk-load vendor concepts via standardized file. Payer concepts can be auto-approved.

 

Project Code Governance

Submissions without a valid project code are rejected at ingestion — not just flagged.

Internalization Pipeline

Identifies high-performing concepts ready to bring in-house and tracks conversion progress.

Concept Performance

Actual recoveries vs. Projections tracked at the concept level — identify top performers and underperformers.

Vendor R&D Oversight

Helps scale proven concepts while directing vendor investment toward emerging opportunities.

"Pareo allowed us to insource more work, reducing our contingency fees and keeping our proprietary business intelligence closer to the vest."

Director, Provider Review Regional Blues Plan

“With Pareo we now have the ability to track how old a claim is getting, and where a claim is in the workflow. This increased visibility allowed us to establish timelines within which the claims need to be addressed, helping us save millions of dollars in write-offs."

Vice President of Payment Integrity

“We’ve been able to internalize about 25% of audits from vendors, reducing the contingency fees paid for these audits from 18-25% for vendors down to 8-12% for Pareo."

Senior Director of Claims Integrity Public Health Plan covering 2.7M lives