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

May 25, 2018

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?


Watch this free payment integrity webinar.

Now’s the time for total payment integrity

See the ClarisHealth 360-degree solution for total payment integrity in action.

Recent Posts

Vendor Consolidation Reduces Payment Integrity Innovation

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?

Reduce False Positives in Healthcare Fraud Detection

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.

ClarisHealth Selected as a Finalist: NBJ 2021 Best in Business Awards

Leading provider of technology platform for health plans one of 20 honorees shortlisted for annual Nashville business award. ClarisHealth is honored to be selected as a finalist for the Nashville Business Journal (NBJ) Best in Business