Payment Integrity in Action with L.A. Care Health Plan

Enjoy our on-demand case study presentation.

What does total payment integrity look like once implemented? To answer that question, we invite you to view “Bringing Total Payment Integrity to Light: A Case Study with L.A. Care Health Plan” an on-demand payment integrity webinar presentation. Health plans, payers and other stakeholders have the opportunity listen to Erik Chase, Director of Payment Integrity, L.A. Care Health Plan and Jason Medlin, Vice President, ClarisHealth discuss in-depth the results achieved with Pareo, ClarisHealth’s total payment integrity platform.

If you’re dissatisfied with your health plan’s current payment integrity program or lack thereof, this exclusive webinar will offer key insights from a ClarisHealth client who has seen tremendous results. Erik Chase will tell you that he was looking for a technology solution when he found a transformation with Pareo.

Why L.A. Care Health Plan Chose Pareo for Payment Integrity

Erik’s desire to seek total payment integrity came from multiple driving needs. For starters, all overpayments the health plan was receiving were unsolicited, meaning that payment integrity was not a proactive effort. In order to change that, Erik needed a payment integrity solution that offered insight and structure to the newly-established payment integrity department, one that could be customized to suit the needs of L.A. Care Health Plan. Vendor management capabilities were also key, as the health plan was bringing on multiple third-party vendors.

The results were impressive. With Pareo, L.A. Care Health Plan saw $30 million in recoveries in the first year, with expectations to increase that to $70 million by the end of 2018. Their payment integrity department has grown to include 30 people and 5 vendors. Not only did this health plan gain insight into their claims processes and operations, but the PI solution was so successful it has encouraged the adoption of modern technologies and processes across the organization.

Why view?

In this webinar, Erik not only discusses how and why he made the decision to work with ClarisHealth, but also gets into details such as future goals for the department, and lessons learned. During this presentation, you will learn how to:

• Expand your vendor footprint – without adding overhead
• Gain greater oversight on claims and operations
• Decide “build or buy” on your technology solutions
• Create a payment integrity nerve center that integrates silo-ed departments

Jason Medlin of ClarisHealth will guide the discussion, posing questions to Erik that highlight some common issues many healthcare payer organizations face when seeking a payment integrity solution, including the internal “sell” and implementation.

On the fence about total payment integrity and how it will benefit you?