ClarisHealth

How are health plans addressing the annual $1 trillion in overspending on healthcare claims payments?  

ClarisHealth, an Inc. 5000 company two years running and recognized as a “major contender” in payment integrity (Everest Group, 2020), is the answer to the health plan industry’s siloed solutions and traditional models for identification and overpayment recovery services. We provide health plans and payers with total visibility into payment integrity and FWA operations through our advanced cost containment technology Pareo®.   

Pareo is the industry’s only comprehensive payment integrity technology platform that maximizes health plan avoidance and recoveries at the most optimized cost. Health plans receive a 15x return on their software investment in Pareo through a 10% rate of avoidance and recovery relative to claim spend, 3x increase in auditor productivity, and a 35% improvement in prepay cost avoidance. Pareo’s configurable approach to payment integrity includes solutions for third-party supplier optimization, auditor workflow and analytics, clinical workflow and analytics, fraud analytics, reporting and business intelligence, and provider engagement.  

As our client Erik Chase, director of payment integrity for L. A. Care Health Plan said, “With the clarity that Pareo has given us, we’re able to track recoveries monthly, and we doubled our recoveries in the first year.”

We are removing the limits of what health plans can achieve in payment integrity and transforming engagement in healthcare.