ClarisHealth Partners with Expion Health to Offer Enhanced Out of Network Claims Management Services on the Pareo® Platform
The leading payment integrity technology platform expands ecosystem to help health plans detect and avoid more claims overpayments, faster.
BRENTWOOD, Tenn., and GAITHERSBURG, Md., October 3, 2024 – Today ClarisHealth, provider of the leading integrated payment integrity technology platform for health plans, announced a strategic partnership with Expion Health. ClarisHealth is pre-integrating Expion Health into the Pareo® platform to offer enhanced out of network (OON) claims management capabilities designed to detect and avoid more claims overpayments without additional IT costs.
The partnership offers health plans a unique alternative to traditional OON offerings: an “outsource-to-insource” model integrated within Pareo’s broader payment integrity ecosystem. Health plans that use Expion realize, on average, $62 to $130 per member per year savings off billed charges for OON claims.
“This partnership takes us even further in our mission to create a better way to drive claims payment accuracy,” said Jeff McNeese, CEO of ClarisHealth. “By pre-integrating Expion Health as a best-in-class services vendor into Pareo, we are able to offer our health plan clients a more comprehensive, efficient and advanced technology ecosystem that accelerates speed to value. This model eliminates the additional IT costs and reduces the implementation times associated with traditional services vendor deployments.”
Expion Health uses its proprietary platform, ExpionIQ, which features enhanced data analytics, predictive modeling, and machine learning, to handle OON claims with precision, leading to fewer errors or rework. Through this partnership, health plan clients can access Expion’s expertise without leaving the Pareo platform or going through a lengthy additional vendor implementation.
Karin Humphrey, CEO of Expion Health, commented on the partnership, saying, “We are thrilled to announce our partnership with ClarisHealth, a move that represents a collaboration of two visionary forces in healthcare cost management. This strategic partnership is grounded in our shared commitment to transforming the payment integrity landscape. 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.”
Pareo is used daily by thousands of users at health plans across the U.S. Its capabilities span the payment integrity value chain, a benefit to health plans wanting to streamline their technology stack.
“Health plans seek advanced technologies to enhance data accuracy and streamline their operations all while lowering ongoing administrative costs,” said Tate McDaniel, chief revenue officer for ClarisHealth. “Pareo’s integration of Expion Health reduces the need for a payer to support and complete work in multiple platforms, so they can realize more value at a lower cost.”
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About ClarisHealth
ClarisHealth, a five-time Inc. 5000 and two-time Deloitte Technology Fast 500 company and recognized in the Gartner Hype Cycle for U.S. Payers and Everest Group’s Payment Integrity Solutions PEAK Matrix® Assessment, provides health plans and payers with a better way to drive claims payment accuracy. Its proprietary, A.I.-powered enterprise technology platform Pareo® has been proven to help health plans streamline payment integrity operations, expand recoveries and reduce administrative costs for an industry-leading ROI.
About Expion Health
Expion Health, pioneers in healthcare cost containment innovation, combines the power of technology and multiple pricing pathways to unlock significant savings across pharmacy and medical claims. Leveraging 30+ years of experience to drive cost savings for health plans, PBMs, TPAs, and self-insured employers, Expion uses cutting-edge technology and robust pricing options and data to address complex factors driving healthcare costs. At the heart of Expion Health’s innovative solutions is the award-winning ExpionIQ platform, which brings together artificial intelligence, automation, and advanced analytics to create powerful solutions for unlocking savings opportunities while ensuring compliance with complex regulations. For more information, visit expionhealth.com.
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