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You play an integral role in the value chain, but data silos, outdated processes, and limited methods of communication with health plan clients can hinder your effectiveness.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.
Latest Blog Posts
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...
read more
Managing Medical Record Requests a problem? We’ve got the solution.
How to manage medical record retrieval processes with multiple clinical audit vendors.Is your health plan missing out on the potential of having multiple clinical audit vendors because you’re concerned about overlapping medical record requests? That uncoordinated...
read more
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...
read more