Healthcare Contract Management and Modeling PartnerOn 7th Jul 2021
Hi and welcome to Revenue Masters, your Healthcare contract management and modeling partner.
Healthcare Contract Management Software Identify All Underpayments and Wrongful Denials
It is recommended to always use a Healthcare contract management software to identify all underpayments and wrongful denials. A good system will help, you know the status of or the reason for underpayments and denials.
If your hospital or practice has old technology with limited functionality, you might not be able to sort claims by underpayments and denials including eligibility, documentation, coding, duplicate claims, or medical necessity edits.
Provider contract management and modeling system should include calculators for:
Value Based Reimbursement
EAPG and APR-DRG Reimbursement
OPPS and IPPS Reimbursement
Tiered allowance discounts for multiple procedures
Reimbursement for multiple complex pair rates, dual stop losses. Case rates, bundle codes, outliers, carve-outs, discharge status codes and more.
Powerful calculators are essential for determining the maximum reimbursement allowed by the pair and comparing it to the amount actually processed. Contract management and modeling is a difference that can make or break your revenue cycle KPIs.