Effective Coordination of Benefits with Medicare

With our Payment Integrity solution, plans can increase post-payment recoveries and limit claim overpayments. We provide a complete and comprehensive review—including potential compliance exposure and mistaken claim payments.

Recoup Lost Dollars and Minimize Compliance Exposure

By applying proprietary analytics and modeling, we identify under- and overpaid claims, helping uncover root causes to resolve issues at the source. With over 20 years of Medicare experience, Pareto Intelligence helps organizations significantly reduce high-cost impacts.

Payment Integrity: Our Coordination of Benefits Solution

  • Identifies and recovers incorrect claim payments
  • Enhances pre-payment services to address issues identified in post-payment review
  • Creates a comprehensive view into improving the entire payment process
  • Provides clients full transparency into the analytics and outcomes of our evaluation

Why Pareto?

icon

Healthcare-Specific

Our solution is built for healthcare and tailor-made for healthcare analytics applications.

icon

Root Cause Focus

We go beyond surface-level gap identification to uncover the root cause of revenue losses to resolve issues at the source.

icon

Flexible

We offer multiple delivery models and present our results in a way that works best for you.

A Powerful Foundation

     
icon

Our Data Management Platform

Pareto’s Data Management Platform, the foundation to our solutions, is built around data lake, artificial intelligence, and open source big data technologies to allow us to effectively ingest data in all formats and types at scale, organize them with appropriate data governance mechanisms within our data catalog, and provide efficient configuration capabilities to democratize data access and analytics.

LEARN MORE

See it and Believe it

Our demos say it all. Tell us about your challenges and we’ll show you how we can help you overcome them.

Schedule a Demo