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Enterprise Layer Intelligence
Categories/Healthcare & Life Sciences/ClarisHealth
ClarisHealth

ClarisHealth

Founded 2013

Manage healthcare claims inventory and audit payments to prevent billing errors

You can use ClarisHealth to manage healthcare claim audits across both prepay and postpay workflows. It brings multiple audit vendors together in one central system so your team avoids overlapping reviews and duplicated fees. The system tracks claim inventories, identifies billing errors, and inspects audit results at the concept level to confirm accuracy. Health plans can also analyze historical claims data, uncover cost containment opportunities, reduce administrative write-offs, and maintain compliance standards like HIPAA and SOC II while handling millions of member claims efficiently.

What ClarisHealth does

Audit health insurance claims for billing accuracyCoordinate third-party claims review vendors in a unified queueTrack claim review status across pre-payment and post-payment stagesCalculate cost containment savings and avoid duplicate vendor feesReview medical code concepts on disputed member claimsGenerate payment integrity reports for payer executive teamsPre-pay and post-pay claims inventory managementConcept-level claim audit tracking and accuracy measurementMulti-vendor coordination to eliminate audit overlapsAutomated claims routing and review queuesAnalytics reporting on cost savings and write-offsBuilt-in compliance monitoring for HIPAA and SOC II

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ClarisHealth, Pareo, payment integrity, claims management, health plan audit, prepay claims, postpay claims, claims inventory, medical billing audit, healthcare payers, fraud waste abuse, claim editing, audit coordination, vendor management, claims analytics, health insurance claims