Payment Integrity Suppliers and Health Plans Collaborate to 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You play an integral role in the value chain, but data silos, outdated processes, and limited methods of communication with health plan clients can hinder your effectiveness.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.
Health plan third-party payment integrity suppliers unintentionally waste time and resources when they …

Lack claims visibility
Need real-time feedback
Work wrong claims

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

When the health plans and payers you work with select Pareo® cloud-based advanced payment integrity technology, everyone benefits.

SHOW YOUR BEST WORK

 

Pareo® is designed to help Suppliers demonstrate their value.

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®.

With Pareo®, health plan Suppliers enjoy …

Greater business opportunities. Pareo® promotes more relationships with business partners and higher-value work for vendors.

Greater supplier efficiency. You only work relevant claims based on your specific health plan arrangement.

Decreased administrative costs. Increased data feed standardization promotes efficiency.

Decreased provider abrasion. Medical record overlap controls ensure you don’t duplicate provider requests.

Focused effort around new concept generation. Deliver additional revenues to your organization.

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