3 Elements Needed to Internalize Payment Integrity

Nov 12, 2021

Season 2: Episode 5

As we’ve followed L.A. Care Health Plan’s story of payment integrity transformation, they have discussed how important third-party services vendors have been to that journey — especially when combined with the efficiencies, oversight and transparency enabled by the program optimization capabilities in Pareo. But their ultimate goal will be familiar to most health plans. How can they do more overpayment detection and prevention with their own resources?

In this episode, Erik Chase and Shonnie Davis tell of how they have combined technology, internal subject matter experts and outside analytics content to maximize the recoveries initiated by their own auditors and analysts.

Joined by Jeff McNeese, Cassie Bishop, Coy Page and Andrew Walters of ClarisHealth who discuss the value of the “outsource to insource” strategic approach to internalize payment integrity. And how health plans can engage in a non-traditional vendor relationship focused on root-cause remediation.

Introducing Payment Integrity Perspectives, A New Podcast from ClarisHealth

Introducing Payment Integrity Perspectives, A New Podcast from ClarisHealth

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 ...
Why ClarisHealth? Telling the story about how health plans innovate.

Why ClarisHealth? Telling the story about how health plans innovate.

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 ...
The Value of Transparency for Health Plan Technology

The Value of Transparency for Health Plan Technology

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 ...
Technology to Answer Your Innovation Goals

Technology to Answer Your Innovation Goals

Season 1: Episode 3 - 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 ...
Reduce Your Health Plan’s Risk When Selecting Advanced Technology

Reduce Your Health Plan’s Risk When Selecting Advanced Technology

Season 1: Episode 4 - How can health plans evaluate the increasing number of technology choices available to them and find a partner to match their vision - without taking on unnecessary risk? ...
How Can Technology Help Health Plans Navigate Complexity?

How Can Technology Help Health Plans Navigate Complexity?

Season 1: Episode 5 - Technology solutions are often the cornerstone of a health plan’s innovation journey. But, as you build your technology stack, ask yourself: Is it simplifying your existing ...
The Importance of Partnership When Adopting Technology

The Importance of Partnership When Adopting Technology

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 ...
How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

How Highmark Uses Pareo for an Integrated Approach to Claims Cost Containment

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 ...
Introducing L.A. Care Health Plan

Introducing L.A. Care Health Plan

Season 2: Trailer - This season, we’re following L.A. Care Health Plan who built a payment integrity function from the ground up – with a little help from advanced technology platform Pareo – ...
Building Payment Integrity from the Ground Up

Building Payment Integrity from the Ground Up

Season 2: Episode 1 - On their way to achieving an annual $131 million recovery rate, L.A. Care Health Plan had to build their team, onboard and manage vendors, and acquire a technology solution ...
Scaling Payment Integrity to Accelerate ROI

Scaling Payment Integrity to Accelerate ROI

Season 2: Episode 2 - When the L.A. Care Health Plan payment integrity team looks at how far they’ve come in 4 short years, the differences are startling. Their early success made the case for ...
Harnessing the Innovation of Payment Integrity Services Vendors

Harnessing the Innovation of Payment Integrity Services Vendors

Season 2: Episode 3 - We can't tell the story of L.A. Care Health Plan's accelerated path to payment integrity results without talking about the efforts of services vendors. Even with their ...
Measuring the Value of Payment Integrity

Measuring the Value of Payment Integrity

Season 2: Episode 4 - One of the primary reasons health plans seek digital transformation is for its potential as a more reliable source of information and insights. L.A. Care Health Plan was no ...
A Vision for Payment Integrity

A Vision for Payment Integrity

Season 2: Episode 6 - This season, as we have followed L.A. Care Health Plan's journey building a payment integrity function from the ground up, we've seen them go from a few thousand in ...