Total Payment Integrity™
More than a vendor. Total Payment Integrity is a 360-degree solution for audit and recovery.
Focus on Transformation
How many times have you been offered empty promises by vendors?
But take away the black box of mystery, and the solution’s magic starts to sound a lot like the same old, same old. The same contingency fees that only allow you to evaluate the vendor’s effectiveness on the same outdated metrics—dollars recovered and claims quality.
If the typical approach were enough, adding another vendor would provide the transformation you need. But where are the new concepts and innovation that allow you to grow recoveries, focus on prevention and optimize costs? Where is the vision that allows your operations to rise above the day-to-day details and reclaim your strategic focus?
Typical Payment Integrity Approach:
What is Total Payment Integrity™?
A 360-degree solution that mutually benefits you, your providers, and your vendors.
ClarisHealth is not just another vendor. We’re about much more than insurance claims recovery—and with ClarisHealth, you won’t experience broken processes. We are a technology-enabled service vendor, but we are also powered by people who help you achieve the greatest results possible through automation, analysis, and insurance claim recovery support.
Our payment integrity systems give you the vision and insights necessary to see what needs to be done with each individual claim. We give you the tools and technology to perform at the top of your game. We partner with you and guide you every step of the way.
It’s not magic. It’s the program integrity solution you would create if you could, and it’s taking payment integrity from complexity to total visibility that brings you optimal payment integrity results.
Our Approach: An Integrated Model for a Fractured Industry
It’s difficult to maintain your focus on optimizing results in total payment integrity when you’re facing increased pressure to control medical expenditures and lower your administrative costs. And, because you may be working in a highly fractured structure of multiple inter-departmental teams, a vast network of third-party vendors, and using antiquated or insufficient technology, which often perpetuates errors and increases costs.
Today’s industry demands that payment integrity organizations have comprehensive solutions that can drive value and efficiency across the entire payment integrity ecosystem.
How could you benefit from the Total Payment Integrity™ approach?
Total Payment Integrity by the Numbers
Do you have the focus needed to address the challenges ahead?
$362 billion: Medical cost savings related to improved payment integrity and decreased overpayments.
$47 billion: Estimated administrative cost savings if plans use predictive modeling to pre-score claims for coordination of benefits (COB), upcoding, subrogation, fraud and medical management prior to payment.
2%: The Industry-accepted rate of recovery, relative to claim spend.
7%: The Optimized rate of recovery, relative to claim spend.
Unleash the Power of an Integrated System
What could you accomplish with Pareo®?
Reveal Real Results
Maximum Financial Returns Today, Innovative Opportunites for Tomorrow.
Lower Administrative Costs by 2-4%
Receive a 10X Return on Investment