WILLIAMSVILLE, N.Y., April 23,
2024 /PRNewswire/ -- Penstock Group announced
today a partnership with Paradigm, an accountable specialty
care management organization and developer of a proprietary payment
integrity program assuring accurate payments for surgical implant
claims.
Penstock, a leader in the healthcare payment integrity space
focused on delivering innovative and niche results, saw a unique
opportunity to integrate Paradigm's robust and established
expertise into their programs to enhance claim accuracy in the area
of surgical implants.
"Paradigm has been a pioneer in value-based care for more than
30 years," says Penstock president Laura
Collier. "Penstock has fairly quickly established a
reputation and track record for finding niches in the payment
integrity space that others overlook. Paradigm's expertise in this
area and Penstock's culture of innovation line up perfectly to
provide full transparency and payment accuracy."
The partnership will include a seamless integration with
ClearBridge, Penstock's comprehensive SaaS payment integrity
solution that facilitates a more effective and efficient claims
auditing process. ClearBridge is an audit management technology
that optimizes workflow and offers seamless self-service for
auditors that negates the need for constant IT assistance,
including intuitive search, advanced reporting and agile edit
development.
"The inner workings of the medical device supply chain and
evolution of the technology of the devices themselves are intricate
and complex," says Collier. "Payers are routinely overpaying in an
area that amounts to more than one-fifth of all surgical
spend."
Paradigm's comprehensive Implant Savings Program identifies
savings opportunities
through expert bill review and industry-specific data, ensuring
accuracy in surgical implant claims. The program delivers an
average savings of 69% for payers.
Paradigm specializes in reviewing charges for surgical implants
— with over 200,000 cases reviewed to date. Paradigm's surgical
implant review experts, in tandem with a proprietary database,
generate savings that far exceed those found using typical surgical
claim review approaches — a key piece to reducing the unnecessary
spend that is so pervasive in healthcare. Ninety-eight percent of
surgical implant cost savings identified by Paradigm are upheld
after any appeal and 88% of total bills remain undisputed.
"This partnership brings together two industry leaders who are
committed to going above and beyond to fix core cost challenges in
the industry and create proven and sustainable solutions," says
Paradigm Chief Networks and Operations Officer Chris Pricco. "By integrating with ClearBridge,
a wider range of payers will have access to Paradigm resources as
part of a comprehensive audit and payment integrity platform."
About Penstock
Penstock is a service partner and SaaS builder for
forward-thinking health plans, empowering recovery, audit and
regulatory teams to get accuracy right from the start—when it
matters most. With payment integrity and regulatory technology and
services, Penstock removes inefficiencies, costly errors and
wasteful spending, ultimately lowering healthcare costs for payer
organizations and their members. Penstock is part of Goodroot,
which launches and scales companies dedicated to increasing access
and affordability in healthcare. penstockgroup.com
About Paradigm
Paradigm is an accountable specialty care management
organization focused on improving the lives of people with complex
injuries and diagnoses. The company has been a pioneer in
value-based care since 1991 and has an exceptional track record of
generating the very best outcomes for patients, payers, and
providers. Deep clinical expertise is the foundation for every part
of Paradigm's business: risk-based clinical solutions, case
management, specialty networks, home health, shared decision
support, and payment integrity programs. Paradigm is headquartered
in Walnut Creek, California, with
offices across the U.S. For more information, please visit
paradigmcorp.com.
Media Contact:
Liz Chasse
376482@email4pr.com
860-254-6668
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SOURCE Penstock Group