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