Are health plans complying with your contract terms? Verify the accuracy of payment received from third-party payers.
You improve contract management with Experian Health’s Contract Manager and Contract Analysis for Hospitals and Health Systems. These powerful solutions continuously audit payer contract performance so you’re assured your collections align with negotiated terms.
Validate reimbursement accuracy
Contract Manager and Contract Analysis monitor payer compliance with contract terms, and value claims and audit remittances based on the latest payment rules and adjudication logic. Hospitals and health systems can easily manage multiple payer contracts and reimbursement methodologies. The integrated solutions pinpoint variance quickly and easily, accurately pricing claims and comparing actual allowed amounts to expected amounts. Because our contract tools are built to adapt to changes within the industry you capitalize on emerging reimbursement schemes and changes in payer payment policies.
Conduct contract-based appeals and recover lost revenue with data-driven insight. In addition to providing details needed for successful appeals and streamlining communications with payers, Contract Manager identifies sources and patterns of errors so recurring issues can be promptly resolved.
Negotiate favorable terms
Contract Analysis supports modeling of proposed contract terms so you can tailor negotiation strategies to maximize reimbursement. It also assesses financial impacts of new and proposed contracts down to how much individual service lines could gain or lose, and lets hospitals strategically evaluate contract performance and assess potential of new lines of business.
For additional information on how your organization can boost reimbursement while lowering billing and payer contract administration costs, click Contact Us button on the right.
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