Payment integrity leaders from the country’s top health plans take time to collaborate at POP Conference 2024. They find strength in community, innovative ideas, and a focus on 4 primary industry drivers.
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Vendor Relationships
Payment Integrity Leaders Reveal What Will Move the Industry Forward
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?
6 Steps to a Successful Prepay Strategy
Health plans can take control of their own prospective provider audits instead of over-relying on services vendors with the help of advanced technology and access to proven analytics. We’ve written before about why it’s important for health plans to start thinking...
An Aggressive Plan to Move your Claims Recovery to Prepay Status
Transitioning more payment integrity operations to internal prepay is more than just a pipe dream for health plans Transitioning prepay. It’s the holy grail for health plans — and viewed as equally unattainable. And, in the not-so-distant past, this viewpoint would...
Managing Medical Record Requests a problem? We’ve got the solution.
How to manage medical record retrieval processes with multiple clinical audit vendors.Is your health plan missing out on the potential of having multiple clinical audit vendors because you’re concerned about overlapping medical record requests? That uncoordinated...
Checking in: How to offer vendors a concierge experience
When we created Pareo®, from its inception we knew vendors would be an important stakeholder in the payment integrity ecosystem. As our payment integrity solution has grown (in many ways, shaped by our incredible clients), it has cemented our belief that focusing on...
Prepare to Meet the Future with Data
We revisit ONC’s Information Blocking Rule, recap public comments, and look at how health plans can meet data sharing requirements. Earlier this year, we wrote about the ONC’s proposed information blocking rule and how it serves as an opportunity for health plans....
What makes value-based care programs work? 3 keys to success
Following up on our previous article, we look more closely at what successful value-based care initiatives have in common. It’s not all that surprising that one of our recent blog posts, Medicare for All: Should it be feared by health plans? has quickly become one of...
Should You Build Your Own Supplier Management Solution?
Take our quiz to help you decide if build or buy is right for your health plan. By now, you likely realize that your health plan needs a way to manage the many third-party vendors that allow you to maximize recoveries and optimize costs. The question is, should you...
How to Vet a Third-Party Vendor for Your Health Plan
Pareo® makes it easier than ever to add third-party vendors to your payment integrity operations. Here’s a list of questions to ask new suppliers when interviewing them. A strategic mix of payment integrity suppliers can propel your health plan’s cost containment...
Top 10 Ways to Maximize Your Health Plan’s Recoveries
Want to maximize your health plan’s recoveries? Of course you do. Here’s how.There’s a great deal of uncertainty in healthcare today, but one thing never changes: health plans’ desire to grow their recoveries. But, stuck dealing with insufficient technology or...
Thoughts on Creating a Centralized Payment Integrity Department
Does it make sense for your health plan to carve out Payment Integrity from your other cost containment efforts into a dedicated department with greater oversight capabilities? Historically, payment integrity efforts have been scattered among specialty departments...
5 Ways Pareo® Benefits Health Plan Vendors
ClarisHealth’s Total Payment Integrity™ solution strengthens vendor partnerships Sooner or later it’s bound to happen: your health plan wants to shake things up a bit. New processes, new technology, new point of contact, bringing new third-party services providers on...
How to Maximize Vendor Partnerships with Pareo®
Payment integrity vendors are critical to the success of any health plan. As health plans realize this, they are working to create stronger partnerships. Here’s how Pareo® helps. We were talking to a health plan recently about our comprehensive payment integrity...
Stop Spinning Your Wheels
How to get your health plan out of a rut and break down big data silos. Health plans are tasked with deriving ever-more savings from their claims overpayment initiatives. But with limited people, strategy, technology or processes to accomplish their goals, are they...
Grow Your Payment Integrity Efforts with Outsourced Vendor Management
An ideal vendor solution for growing PI departments Building and running a payment integrity department isn’t easy – or inexpensive. There will likely be hurdles along the way, and it isn’t as if the rules around improper payments and claims management are standing...
Health Plan Vendors Don’t Have to Be a Hassle … If They’re Well Managed
Gain the oversight you need to manage your health plan’s third-party services providers. Recently, a client shared with us that the IT cost to bring on a health plan vendor was $70k. That stopped us in our tracks. $70k is, in our opinion, way too much for a health...
Maximize Value & Partnership with Your Third-Party Payment Integrity Vendors
Ask yourself these 6 questions to get the most from your payment integrity vendors. Looking to get the most out of your third-party payment integrity solution vendors? Consider asking yourself the following questions to determine if your vendors are providing you with...