Explore our patented and award-winning healthcare data analytics and technology solutions.

Revenue Integrity

Our Revenue Integrity solution helps address the complexities that impact the completeness, accuracy, and compliance of clinical documentation. We deliver market-leading analytics and business-ready access to drive clinical documentation operations, measure performance, and set the right strategies to improve long-term outcomes.

Powered by The Pareto Hub, our patented cloud-based platform gives users unparalleled access to insights through a ready-to-analyze data environment.

Premium Integrity

Our Premium Integrity solution recovers lost revenue retrospectively and proactively improves premium accuracy by focusing on the various adjustment factors that impact Medicare Advantage premiums, including:

• Medicare Secondary Payer (MSP) status
• Dual Eligibility
• End stage renal disease (ESRD) entitlement determinations

Our approach is full-service and results in timelier and more accurate enrollment and revenues.

Payment Integrity

Pareto’s Payment Integrity solution comprises pre- and post-payment modules to improve accurate Medicare Secondary Payer (MSP) determinations and claims coordination of benefits (COB).

We support health plans with Section 111 CMS reporting requirements, perform advanced analytics to identify mistakenly paid claims, and improve future claims payment accuracy.

Supplemental Benefits

Combine supplemental benefit data, claims, and enrollment information to better understand member behavior in order to strengthen the effectiveness of popular supplemental benefits programs. Uncover opportunities to engage members holistically and align behaviors with health plan clinical programs tailored to improve outcomes. 

Read about how we did this with an OTC benefit program.

Revenue Integrity

Our Revenue Integrity solution helps address the complexities that impact the completeness, accuracy, and compliance of clinical documentation. We deliver market-leading analytics and business-ready access to drive clinical documentation operations, measure performance, and set the right strategies to improve long-term outcomes.

Powered by The Pareto Hub, our patented cloud-based platform gives users unparalleled access to insights through a ready-to-analyze data environment.

Premium Integrity

Our Premium Integrity solution recovers lost revenue retrospectively and proactively improves premium accuracy by focusing on the various adjustment factors that impact Medicare Advantage premiums, including:

• Medicare Secondary Payer (MSP) status
• Dual Eligibility
• End stage renal disease (ESRD) entitlement determinations

Our approach is full-service and results in timelier and more accurate enrollment and revenues.

Payment Integrity

Pareto’s Payment Integrity solution comprises pre- and post-payment modules to improve accurate Medicare Secondary Payer (MSP) determinations and claims coordination of benefits (COB).

We support health plans with Section 111 CMS reporting requirements, perform advanced analytics to identify mistakenly paid claims, and improve future claims payment accuracy.

Supplemental Benefits

Combine supplemental benefit data, claims, and enrollment information to better understand member behavior in order to strengthen the effectiveness of popular supplemental benefits programs. Uncover opportunities to engage members holistically and align behaviors with health plan clinical programs tailored to improve outcomes. 

Read about how we did this with an OTC benefit program.