Optimize Section 111 Reporting

Our Payment Integrity solution combines advanced analytics with the complex regulatory requirements of the Centers of Medicare and Medicaid Services (“CMS”) to identify and prioritize potential Commercial, Individual, and ACA claim overpayments made by health plans due to incorrect or missing Medicare primacy information.

We Help Plans Navigate CMS Reporting Complexities

By modernizing the collection and management of reporting to CMS, we help plans ensure compliance with regulatory requirements, reduce the number of errors received on submissions, and minimize dependencies on error resolution.

Payment Integrity: Our Section 111 Reporting Solution

  • Helps plans remain compliant with CMS
  • Improves pre-payment accuracy, resulting in more accurate primacy determinations
  • Reduces the amount of post-payment discrepancies
  • Minimizes dependency on recovery vendors
  • Provides clients full transparency into the analytics and outcomes of our evaluation

Why Pareto?


Gain Efficiencies

Proactively correcting inaccurate primacy determinations reduces reliance on post-payment analysis and recoveries.


Reduce Administrative Burden

Our propriety analytics and modeling significantly reduce health plan efforts.


Improve Compliance

Looking both ways to identify and correct under- and overpayments reduces potential compliance exposure.

A Powerful Foundation


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.


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