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What is Pareto Intelligence?

Pareto Intelligence is a cutting-edge platform focused on healthcare analytics and technology, dedicated to boosting the financial health and compliance of health plans and risk-bearing provider organizations while simultaneously enhancing clinical communication and outcomes within value-based care frameworks. At its core, it features a centralized healthcare data environment that integrates, standardizes, and enriches diverse clinical, claims, and social determinants of health data, offering holistic insights into patients and programs that support sophisticated analytics and reporting. Its suite of tools includes risk adjustment and revenue integrity solutions that uncover undocumented risk gaps, improve risk scores, assist with RADV audit readiness, reconcile premiums, and ensure full and compliant revenue capture. Furthermore, Pareto offers payment integrity solutions that pinpoint both underpaid and overpaid claims, thus improving Section 111 reporting and benefit coordination. By harnessing these advanced capabilities, healthcare organizations are empowered to make data-driven decisions that can lead to enhanced patient outcomes, operational efficiency, and overall quality of care. This innovative approach not only streamlines processes but also fosters a culture of continuous improvement within the healthcare sector.

What is MemberMatch?

The process of claims can extend over several months, which complicates the management of related expenses as time progresses. A slight delay of just a few minutes in identifying patient activities can trigger an unnecessary and costly admission to the hospital, a factor that is vital for effective care coordination and the success of value-based contracts. MemberMatch offers these essential insights in real time, providing care teams with the timely information they need to proactively and efficiently manage ongoing care episodes. This strategy aids organizations that bear risk in improving the quality of care while also considering the financial impact of each member interaction throughout the continuum of care, leading to better patient outcomes and enhanced financial health for the entities responsible for their care. By fostering communication between your care team and the involved clinical staff, valuable context is delivered to enhance both the quality and cost-effectiveness of care encounters, which in turn helps to avoid unnecessary admissions to out-of-network facilities and duplicate testing. Ultimately, this timely data equips healthcare providers with the knowledge necessary for making decisions that can greatly benefit both the patients and the organizations they serve, ultimately fostering a more efficient and patient-centered healthcare system.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Pareto Intelligence

Company Location

United States

Company Website

paretointel.com

Company Facts

Organization Name

Experian Health

Date Founded

1994

Company Location

United States

Company Website

www.experian.com/healthcare/products/care-management/manage-aco-passport-to-health-membership

Categories and Features

Categories and Features

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