Pareto Intelligence

Did you know? Risk adjustment was originally developed to ensure fair Medicare payments, but today, it’s already being used in private insurance and other public health programs like ACA! At Pareto, we’re not just talking about it—we’re actively transforming MA and ACA plans, helping healthcare providers receive fair reimbursement based on patient health status. Through smarter analytics, we’re ensuring accurate, equitable care for all—no matter how complex the population. #ParetoIntelligence #RiskAdjustment

Why focus on Revenue, Payment, and Premium Integrity? Each is crucial for maximizing the value of your healthcare data. Just like different tools serve specific functions in a toolkit, these solutions equip you to ensure financial accuracy, operational efficiency, and compliance. Explore how integrating these elements can improve your data management and drive better outcomes.

Next, let’s explore Payment Integrity! This solution suite combines advanced analytics with CMS regulations to identify and prioritize potential overpayments in Commercial, Individual, and ACA claims. It’s like having a financial detective on your team, catching errors from incorrect or missing Medicare primacy information. Clients often see a 6:1 ROI with recoveries averaging $5 to $7+ PMPY. Learn how Payment Integrity solutions can enhance your payment processes and reduce compliance risk. #PaymentIntegrity #ClaimsAccuracy #Section111 #CoordinationofBenefits

Introducing Premium Integrity! This solution suite navigates complex Medicare reporting, including Medicare Secondary Payer (MSP), Dual Eligibility, and End Stage Renal Disease (ESRD). It helps uncover and correct inaccuracies in CMS reporting, ensuring accurate premium reconciliation. Think of it as a powerful tool for identifying and recovering mistaken premium payments. Our clients have achieved an average 5:1 ROI, with over $100 million in recoveries to date. Discover how Premium Integrity solutions can enhance your premium management and compliance. #PremiumIntegrity #HealthcareAnalytics

Welcome to Revenue Integrity solution suite, which includes our cornerstone risk adjustment platform, the Pareto Hub. This cloud-based platform centralizes and transforms your raw data into actionable insights. Think of it as your financial GPS, guiding you through complex data landscapes and streamlining your operations. While the Hub offers robust capabilities, additional solutions like the Provider Learning Center can be added to ensure accurate risk capture at the point of care. Take control of your data and enhance analytics with a centralized platform that scales with your needs. #RevenueIntegrity #ParetoHub https://hubs.ly/Q02YytHn0

Pareto Intelligence is excited to sponsor the RISE Risk Adjustment Forum! Visit our booth for: - Live demos of our risk adjustment solutions - Advisory services to help you avoid regulatory pitfalls - Insights on building a strong compliance culture to reduce risk (be sure to check out our latest article on this topic) In our article, Avoiding Regulatory Scrutiny Through a Strong Risk Adjustment Compliance Culture, we explore strategies to mitigate compliance risks and drive better outcomes. Don’t miss the opportunity to meet our experts: Eric Shapiro Christopher Steibel Abigail Tsui Tegan Brace https://bit.ly/4evVItC

A strong foundation is essential for any successful structure, and the same applies to data management. Just as a sturdy foundation supports a building, robust data integrity underpins effective decision-making and strategic planning. By focusing on data accuracy and integrity, we help organizations build a reliable and effective data infrastructure. #DataFoundation #StrategicSuccess

A single data error can have far-reaching consequences, much like how a small mistake in financial statements can lead to significant discrepancies. For instance, recent reports on inaccurate insurance claims demonstrate how data inaccuracies can affect financial stability and compliance. Pareto Intelligence focuses on meticulous data management to prevent such issues and ensure accuracy in every aspect of data handling. We offer expert advisory services to help you manage and ensure data accuracy, so you don’t have to face these challenges alone. #DataErrors #OperationalEfficiency

Recent high-profile data breaches emphasize the critical need for robust data integrity. Just as strong cybersecurity measures protect sensitive information, data integrity ensures that your data is accurate, consistent, and reliable. We prioritize data integrity to safeguard against inaccuracies and maintain trust. Our commitment to rigorous data practices supports secure and effective data management. #DataIntegrity #DataProtection

Advanced analytics is like using a GPS for navigating unfamiliar terrain. Just as GPS helps you find the best route, analytics transforms raw data into actionable insights, guiding strategic decisions. Pareto’s focus on analytics helps clients chart a successful course through complex data landscapes. #Analytics #DataDrivenDecisions