How can your health plan control your prepay strategy?
“Our vision for payment integrity is to move from a predominant outsource to a predominant insource business model. It is a bold strategy, and we needed an equally bold and innovative partner. We explored many options, including an internal build, until we were introduced to ClarisHealth and Pareo. After the first demonstration of Pareo, we knew that it had tremendous potential to serve as the foundational payment integrity hub to realize our vision.”
Are your third-party services vendors getting you any closer to a payment integrity mix that prioritizes internal, prepay audits?
Most health plans have thrived for years with a cost containment strategy that relies primarily on external post-pay efforts.But thistraditional “pay and chase” approach increases administrative costs – for both payers and providers – as well as provider abrasion. Today, innovative health plans are leveraging advanced technology to move more payment integrity efforts to internal prospective claims validation and maximize avoidance at the most optimized cost while improving provider relationships.
In this complimentary executive brief you’ll learn:<
- What you can gain from transitioning more cost containment efforts prepay
- How to identify the 4 characteristics of an inefficient payment integrity process
- What you can do to overcome your challenges to executing on prepay – even if you struggle with concept development
- The proven step-by-step process for health plans seeking to optimize their mix of prepay avoidance and post-pay recovery efforts
Take the next step toward cost avoiding 30% of all plan savings.