Industry Insights & Expertise
Access insights and perspectives from our team of payment integrity and FWA experts. Our podcast ‘Payment Integrity Perspectives’ features innovators and thought leaders who share a common goal to transform health plan engagement.
Articles
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With advanced technology, health plans can take control of their medical claims audits while achieving high ROI. Here's how.
Leading provider of technology platform for health plans one of 8 honorees selected for annual Nashville business award.
ClarisHealth is honored to be declared a winner of the 2021 Nashville ...
What steps should your health plan take to ensure you get the most value from your services vendors and payment integrity efforts in the face of vendor consolidation?
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.
Payment integrity evolves into a more strategic function for health plans in order to reduce overall healthcare expense. Prepay drives greater cost savings but can be difficult to achieve. Here, ...
What can your Medicaid MCO do to prepare for this year and beyond?
Medicaid managed care organizations are continually in a balancing act, facing tighter-than-average budgets, political ...
Look out for these 4 elements of payment integrity that may negatively impact provider NPS (net promoter scores) with your network providers.
The Net Promoter Score (NPS) – an established metric ...
Competing with other health plan functions for technology priority can lead to missed audit claims cost savings potential. An integrated payment integrity strategy breaks down these internal ...
Part 1 of our series on how the SIU can use artificial intelligence to overcome common challenges. Bringing together fraud and payment integrity efforts on a single A.I.-powered platform can ...
Resources
Off the shelf, Pareo met the 500 capabilities Blue Cross Blue Shield of Michigan required in order to modernize their payment integrity system.
In this on-demand webinar, Kurt Spear of Highmark Blue Cross Blue Shield demonstrates how they adopted and continue to scale their use of Pareo to realize their vision for improved efficiency, ...
Download our FREE technology adoption whitepaper, filled with insights from payment integrity leaders.Access the ultimate guide for health plans seeking digital transformation.
In this in-depth ...
In this on-demand webinar, Mark Isbitts, VP of Program Integrity at ClarisHealth discusses how you can use A.I. for healthcare fraud detection to answer SIU questions.
Are your third-party services vendors getting you any closer to a payment integrity mix that prioritizes internal, prepay audits?
Now that advanced solutions that harness the power of artificial intelligence have emerged for fraud detection, is it the right solution for your organization to hit escalating fraud recovery ...
In partnership with NHCAA, ClarisHealth hosted a live educational webinar to talk with health plan fraud teams about how advanced technology - specifically solutions that employ artificial ...
In this on-demand webinar, helmed by healthcare fraud and data science experts with decades of experience in the payer space, we break down common misperceptions around artificial intelligence ...
Combating Novel Fraud in the Age of a Novel Virus
ClarisHealth VP of Program Integrity Mark Isbitts joins VP of Marketing and Business Development Jason Medlin to offer 6 steps your health plan ...
Recent Podcasts
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 ...
Season 1: Episode 6 - How your technology solution is delivered, and by whom, is a large factor when considering how successful a technology project will be. In this episode, ClarisHealth experts
Season 1: Episode 5 - With your health plan’s goals around digital transformation and the increasing number of technology choices available to you, you may start to ask yourself: Are you doing ...