Streamline Communication and Promote Innovation

You play an integral role in the value chain, but data silos, outdated processes, and limited methods of communication with health plan clients can hinder your effectiveness.

Historically, the relationship between health plans and their business partners has been characterized by inefficiency and a lack of real-time visibility into performance. A lack of transparency in processes seems to be at the crux of the issue.

How can payment integrity suppliers prove their worth to the health plans they serve and drive higher value for both of them?

Vendors and health plans should be more tightly connected around:

Claims that should be worked

Audit rejections and rationale

Approval of new concepts

Feedback on overpayments

Performance reporting

Invoicing and payments

Medical records requests

“Before implementing Pareo®, our vendor invoice reconciliation took 30 days or more. After Pareo® was implemented, this same task takes no more than 5 days.”

Payment Integrity Manager, State Health Plan

Demonstrate Your Value

 

Pareo® Supplier gives vendors transparency and access to necessasry data to showcase performance.

Receive and work only the claims relevant to you based on your specific contract, business arrangement, and pass order with health plans

Submit audit findings effortlessly and more frequently using standardized data feeds

Receive health plan feedback more seamlessly on audit acceptance, rejections and rationale

Help the health plan reduce provider abrasion by limiting medical records requests on the same audit

Submit concepts with claims-relevant data in a more organized and efficient manner to receive faster approvals

Eliminate the need to generate invoices and the timely and costly reconciliation and dispute process with health plans

Get paid faster

Standardize data feeds across your entire health plan customer base to maximize IT resource efficiency

It’s easy to work with Pareo®.

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:

Reduce False Positives in Healthcare Fraud Detection

Part 2 of our series on how the SIU can use artificial intelligence to overcome common challenges. A.I. can reduce the fraud false positive rate to make the most of your limited investigator resources.

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

Live on April 8th, 2021 - Proven strategies from Kurt Spear of Highmark Blue Cross Blue Shield demonstrate how they adopted and continue to scale their use of Pareo to realize their vision for improved efficiency, effectiveness and ...

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, ...