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Payer Contract Management for Hospitals

Improve Contract Management and Performance

In an increasingly complex healthcare environment, it is difficult to verify that payers are complying with contract terms. Built on years of reimbursement knowledge and industry best practices, Experian Health Contract Management represents an innovative approach to verifying the accuracy of payment received from third-party payers.

Validate Reimbursement Accuracy

Monitor payer compliance with contract terms, value claims and audit remittance based on the latest payment rules and adjudication logic. This powerful technology platform enables providers to manage multiple payer contracts and reimbursement models. By accurately pricing claims and comparing actual reimbursement to expected payment, this market-leading product pinpoints payment variances quickly and efficiently. The payer contract management solution is built to adapt to changes within the industry so you can capitalize on emerging reimbursement models, such as Accountable Care Organizations (ACOs).

Recover Underpayments

Conduct contract-based appeals and recover lost revenue with data-driven insight. In addition to providing the details needed for successful appeals and streamlining communications with payers, Contract Management identifies sources and patterns of errors so any recurring issues can be promptly resolved.

Additional benefits include:
  • Improved tracking of chargemaster accuracy
  • Streamlined workflow with claims auditing across an organization
  • Lower billing and contract administration costs
  • Fewer registration, coding and posting errors

Experian and the Experian marks used herein are service marks or registered trademarks of Experian Information Solutions, Inc. Other product and company names mentioned herein are the property of their respective owners.