Healthcare contract modeling software

THE ONLY CARE MANAGEMENT SOFTWARE YOU WILL NEED. What is contract modeling? Using historical contract data , contract modeling software allows your healthcare organization to model thousands of various reimbursement combinations to understand the impact of the proposed payer contractual terms on your bottom line. Revenue Masters offers integrated healthcare payer contract modeling and management services at percent of the cost of other software.

Revenue Masters is the most modern, powerful, accurate and affordable healthcare contract management software , all while being the undisputed price performance leader. As the leader in health care contract management software companies, we deliver: 5-10x return on investment based on historical client performance Improved recovery due to accurate underpayment identification Complete government coverage, including Medicare, TRICARE, Medicaid and Workers’.

Reimbursement Manager A contract modeling and claim repricing solution for health plans that want to assess alternative pricing options, monitor contract compliance , and evolve reimbursement strategies. Our contract modeling and analytics software helps organizations predict and manage payments, using a data-driven approach for improved payer negotiations. Estimate net revenue by patient and better manage contracts , claims, and payments. Healthcare contract modeling is essential for any healthcare provider to ensure 1percent collections from payers.

For healthcare organizations struggling to maintain consistent revenue integrity within their revenue cycle, effective contract modeling may be the best long-term solution. Not only does contract modeling allow providers to evaluate the performance of their current payer contracts , but, more importantly, it allows providers to develop a payer strategy that helps drive those payer contracts to deliver more predictable and reimbursement. Supero Healthcare Solutions has extensive experience assisting providers in managed care contract analysis, negotiation, and revenue capture.

We have expertise in every step of the managed care process, from defining the contracting strategy , to modeling the revenue impact of contract terms, to negotiating contracts and resolving payment disputes. The result of these projects is often thousands of dollars in extra revenue.

Over the years our systems have identified tens of millions of dollars in unpaid and underpaid claims to hospitals all over the country. Leverage a centralized repository of contract templates to improve the use of approved contract terms. Improve payment accuracy with clear, standardized terms. Ensuring that contracts are accurately represented in payment systems helps you uncover savings and secure provider support for future value-based payment initiatives. 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. Have you heard that using Epic’s contract modeling tool is the best, most accurate tool for your hospital-based contracts? If you are finding it challenging to keep up with all of the the complex reimbursements models and variations that the Payers are developing to advantage themselves , you should consider utilizing Epic’s Resolute module to manage your Payer contracts.

Axiom Contract Management solutions enable health systems to more effectively and intelligently transition from traditional fee-for-service to fee-for-value reimbursement models. These contract modeling and analytics tools help organizations to better predict and manage reimbursement and leverage a data-driven approach for improved payer negotiations. Improve Payer Negotiations with Contract Modeling After healthcare providers have established contract governance, this historical data can now be leveraged to aggressively model payer contracts in real-time while using the same platform to develop a competitive rate setting strategy and understanding the impact on their current contracts and net patient revenues. Payer contract management for Medical Groups, Hospitals and Health Systems Let us help you make sense of the growing volume and complexity of payer contracts and gain leverage when negotiating with payers. Now you can perform reporting and business intelligence with ease.

Healthcare Industry Contracts, Compliance, and Management Software The healthcare industry has one of the largest and most tedious paperwork loads of any industry. A substantial portion of that paperwork doesn’t have anything to do with medical information, but instead has to do with managing contracts and other types of legal documents. We use our powerful contract modeling software, the RMReimbursement Maximizer, to model your contracts and then audit and collect on all commercial managed care “zero-balance” claims.

Along with payment variance audit and recovery, we also provide a monthly summary that includes a detailed analysis of payer activity, source reasons for underpayments and denials, and recommendations to stop future cash loss. In a prime contractor model, the CCG contracts with a single organisation (or consortium) which then sub-contracts individual providers to deliver care.

The CCG retains overall accountability for the commissioned services, while the prime contractor holds each of the sub-contractors to account individually.