Pareo® Partner Exchange integration expands payment integrity technology ecosystem to help health plans accelerate their insourced prepay strategy.
BRENTWOOD, Tenn. and SAN FRANCISCO, May 8, 2025 /PRNewswire-PRWeb/ -- Today ClarisHealth, provider of the leading integrated platform for health plans, announced a strategic partnership with CoverSelf on ClarisHealth's Pareo® Partner Exchange. This partnership introduces the industry's first end-to-end self-service prepay edit application integrated with a comprehensive payment integrity platform to support health plans in internalizing payment integrity functions and reducing administrative spend.
With payment integrity administrative expenses for recoveries adding up to as much as $50 per claim and pre-payment vendor contingency fees reaching an all-time high, health plans are increasingly looking to cost-avoiding claims overpayments with their own auditor resources. However, they often lack the analytics capabilities, program insights, and operational workflows to pursue this strategy efficiently. The native internal audit management capabilities of Pareo, augmented by the CoverSelf patented solution, connect prepay and post-pay activities in one streamlined platform to eliminate costly manual processes, high contingency fees, and various data integration costs.
"This partnership is another step in our mission to create a better way to drive claims payment accuracy," said , CEO of ClarisHealth. "Health plans are demanding a fully integrated prepay solution, combining next-generation analytics with a complete payment integrity operating platform. Pareo empowers a health plan to take full control of their payment integrity strategy and eliminates point siloed solutions that prevent a plan from maximizing payment integrity value at the lowest possible cost. We are thrilled to partner with CoverSelf and bring this transformative data-driven set of capabilities to market."
According to ClarisHealth , fees associated with outsourced prepay initiatives, including secondary editing services, rank among the highest administrative costs for payment integrity. The pressures leaders face to reduce these costs is making them look more closely at how to internalize more prepay claim reviews.
CoverSelf's proprietary, patented self-manageable payment policy and editing platform features built-in industry-standard concepts and edits sourced from trusted references such as CMS, AMA, Medicaid and others applicable across all claim types, specialties and lines of business. Instead of requiring months to build new prepay edits while relying on resources outside of the payer's control, the CoverSelf CREOL language model puts all the control of edit design and testing at their fingertips to make the most of limited time and money.
Rajasekhar Maddireddy, founder of CoverSelf, commented on the partnership, saying, "Payment integrity leaders and their teams long have desired the ability to have better control and influence over their prepay strategy, and we are proud to provide best in class technology that puts them in the driver's seat. Partnering with ClarisHealth and integrating with the Pareo platform presents an unparalleled opportunity to fully optimize the entire payment integrity value stream. We are thrilled to partner with ClarisHealth."
Pareo is used daily by thousands of users at the nation's top health plans. Its capabilities span the payment integrity value chain, a benefit to health plans wanting to streamline their technology stack. The expands these capabilities while significantly reducing the time and cost associated with implementing new payment integrity solutions. What once took years and millions of dollars can now be accomplished in a matter of weeks, allowing health plans to see results faster.
"Payment integrity leaders understand that having greater control over their strategies and full visibility into their operations offers distinct advantages over the vendor-led models of the past," says Nick Ridings, SVP of health plan partnerships for ClarisHealth. "Integrating CoverSelf into the Pareo Partner Exchange offers the fastest, most cost-effective model for avoiding claims overpayments."
Health plan leaders looking for more information about the CoverSelf integration with Pareo or the Pareo Partner Exchange are encouraged to contact our partner team at [email protected].
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 vendor and existing system spend for an industry-leading ROI. For more information please visit .
About CoverSelf
Founded in 2021, CoverSelf is a generational leap forward in healthcare claims and Payment Integrity architecture, built from the ground up for healthcare-specific use by passionate domain experts and strong technology professionals with decades of experience in addressing the pain points faced by providers and payers when dealing with the latest technological advancements. The CoverSelf Payment Integrity Platform engages modern technologies to address payment leakage and claims inaccuracies while remaining transparent and accessible to payers. The platform empowers payers to prevent and adapt to the ever-evolving claims and payment inaccuracies. For more information, please visit .
Media Contact
Amanda Bair, ClarisHealth, 1 8554252747, [email protected],
Rajasekhar Maddireddy, CoverSelf, [email protected],
SOURCE ClarisHealth
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