Pareo is a payment integrity management platform designed for health plans to reduce improper payments and optimize claims processing. The platform unifies data from claims adjudication and other systems, providing a single view that supports secure access for all stakeholders and fosters collaboration across payers, providers, and auditors. With analytics and predictive modeling, Pareo scores claims for overpayment risk, surfaces root causes, and enables remediation workflows while tracking prompt payment deadlines to prevent leaky processes. Pareo fully integrates fraud, waste, and abuse (FWA) capabilities by linking SIU functions with payment integrity, reducing manual work, provider abrasion, and enabling enterprise-wide governance. Additional capabilities include inter-plan invoicing, vendor management, FWA case management, internal audit management, and robust reporting, delivering timely insights and measurable efficiency gains.

Pareo Platform Capabilities address end-to-end payment integrity needs by offering data management, inter-plan invoicing, vendor management, FWA case management, internal audit management, and comprehensive reporting. These capabilities enable health plans to maintain control over claim inventories, streamline financial interactions between plans, providers, and vendors, and drive evidence-based remediation. The result is a more accurate, efficient, and transparent claims payment process that supports compliance, governance, and strategic decision-making across large payer organizations.

Features & Benefits

• Data Management: Pareo integrates with claims adjudication and other data systems to offer claim inventory controls, including global exclusions and overlap management.
• InterPlan Invoicing: Integrated management of inter-plan invoicing and reconciliation activities.
• Vendor Management: Never access another vendor portal again. Our solution economizes vendor management so that your team – and third-party vendors – can focus on high value work.
• FWA Case Management: Track leads and cases with integrated and streamlined workflows, allowing for comprehensive program integrity managed.
• Internal Audit Management: Features that support internal audit operations, both complex, and non-complex. Plus, access to our experienced team of payment integrity ideation consultants.
• Reporting: Timely insights into operational, vendor, audit, and team KPIs.