Payment Integrity industry’s first integrated ecosystem set to accelerate value delivery and reduce administrative complexity in $9 billion market. Groundbreaking offering addresses the growing complexity in vendor management and empowers health plans to leverage innovative solutions within Pareo and manage their end-to-end payment integrity program.
ClarisHealth, a leader in payment integrity technology solutions serving top health plans across the U.S., today announced the launch of Pareo® Partner Exchange, the healthcare industry’s most comprehensive network of pre-integrated payment integrity solutions. This groundbreaking offering addresses the growing complexity in vendor management and empowers health plans to leverage innovative solutions within Pareo and manage their end-to-end payment integrity program.
The payment integrity vendor solutions market is currently valued at $9 billion with a CAGR of 7%, according to McKinsey. As many new vendors enter the market, health plans face increasing administrative challenges in integrating and managing these diverse solutions. The Pareo Partner Exchange tackles this issue head-on by providing a seamless, integrated ecosystem delivered directly through ClarisHealth’s flagship Pareo platform.
“With successful integrations across every major claims system and over 20 leading payment integrity vendors, ClarisHealth has positioned itself as a source of truth in the payment integrity space,” said Jim Weathersby, CTO at ClarisHealth.
Mike Kriz, CIO for ClarisHealth added, “By eliminating the need for health plans to manage multiple integrations and data feeds, we’ve significantly reduced their cost of doing business. This efficiency allows our vendor partners to accelerate value delivery to health plans by up to 30% year-over-year.”
Recent studies have quantified the impact of Pareo for health plan clients and their vendor partners. Hobson & Company, a third-party consultant, found that Pareo reduces payment integrity administrative spend and increases savings by 30%. The platform eliminates vendor IT costs, which typically range from $250,000 to $1 million in upfront fees and $40,000 per vendor annually. Additionally, write-offs were reduced by 15%, and internal auditor productivity increased by 30%.
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“We’re not just offering a single A.I. vendor or clinical audit solution,” said Sara Thomas, VP of payer solutions at ClarisHealth. “We’re empowering our clients to choose the best partners for their needs while removing the traditional barriers to implementation. With Pareo Partner Exchange, health plans can configure vendor relationships, automate data management, create exclusions, adjust pass orders, reconcile invoices, and identify the root causes of claim payment errors – all within a single, unified platform.”
The Pareo Partner Exchange significantly reduces the time and cost associated with implementing new payment integrity solutions. What once took years and millions of dollars can now be accomplished in a matter of weeks, allowing health plans to see results faster.
“Payment integrity has long needed a single source of truth, and Pareo is delivering just that,” said ClarisHealth CEO Jeff McNeese. “As the only solution in the industry that integrates internal payment integrity audit teams and external vendors for health plans of all sizes and segments, we’re uniquely positioned to transform how health plans work with their partners. The Pareo Partner Exchange is set to accelerate this transformation dramatically.”
ClarisHealth recently announced its first formal Exchange partner, Expion Health, offering an innovative “outsource-to-insource” model for out-of-network claims management. Health plans utilizing Expion’s services have reported average savings of $62 to $130 per member per year on billed charges for out-of-network claims.
Karin Humphrey, CEO of Expion Health, when commenting on the partnership said, “Together, we are poised to enhance the financial health of plans and payers, ensuring they remain in control of their processes and savings. By aligning our innovative technologies and strategic insights, we’re not just preparing for the future, we’re defining it.”
In the coming months, ClarisHealth plans to announce partnerships with several more solution providers, including integrated clinical audit solutions, specialty audit services, AI-powered tools, and data connectivity partners. These upcoming collaborations will further expand the capabilities of the Pareo Partner Exchange, offering health plans an ever-growing suite of integrated solutions to address their evolving needs.
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