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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Slim margins, fewer resources, and consolidation have made it harder for health plans to compete. Could balancing outsource vs insource efforts accelerate their goals?
With shrinking margins, ...
Take this interactive self-assessment to evaluate your current SIU successes and determine your health plan’s need for advanced technology to level up your fraud, waste and abuse mitigation ...
Health plan SIUs find deep learning models for fraud detection provide advantages over rules-based tools.
The onset of the novel coronavirus pandemic highlighted a glaring weakness in ...
A robust fraud, waste and abuse program at MCOs and MAOs includes three key areas: Technology, Clinical Audit and Investigative capability.
As your health plan grows its fraud, waste and abuse ...
Health plans can take control of their own prospective provider audits instead of over-relying on services vendors with the help of advanced technology and access to proven ...
Are you using an assortment of software tools to do work better suited to a platform? You might be missing out.
When your health plan starts looking to upgrade your payment integrity and fraud ...
News
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Now that the rules promoting interoperability have been finalized, here’s how payers can prepare to take full advantage of the freer exchange of healthcare data.
On March 9, 2020, the two ...
Doug Ghertner and George Lazenby, IV, add significant expertise to the healthcare payer technology company’s board of directors
NASHVILLE, Tenn., Jan. 30, 2020 – ClarisHealth, the company ...
Industry veteran will extend ClarisHealth’s strategic direction in accelerating adoption of market-leading technology solutions for health plans.
NASHVILLE, Tenn., Jan. 20, 2020 – ClarisHealth, ...
ClarisHealth VP of Program Integrity Mark Isbitts envisions a “better way” to FWA management, announces release of Pareo Fraud at 2019 NHCAA Conference
NASHVILLE, Tenn., October 21, 2019 – At ...
25-year industry veteran will extend ClarisHealth’s strategic direction in growing and building market-leading technology solutions for health plans.
NASHVILLE, Tenn., July 2, 2019 – ...
HITRUST CSF Certification validates ClarisHealth is committed to meeting key regulations and protecting sensitive information.
NASHVILLE, Tenn., April 17, 2019 – ClarisHealth, a leading ...
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Recent Podcasts
Season 1: Episode 2 - How exactly does advanced technology help health plans innovate? In this episode, ClarisHealth payment integrity experts Jim Weathersby, Michael Gilbertson and Jason Medlin ...
Season 1: Episode 1 - Why is ClarisHealth telling the story about how health plans innovate? In this episode Jeff McNeese, Tara Dufrene and Ryan Nowers tell about the origins and early days at ...
Season 1 Trailer - In this teaser, host Amanda Bair (ClarisHealth) features insights from company leaders to offer a unique perspective on payment accuracy by looking at the problems modern ...