Using data to manage payer/provider health contracts and CMS reimbursements is a powerful way to recover lost revenue. The process of analyzing contract payments and CMS calculations uncovers inaccuracies, identifies strategies to proactively increase future payments, and informs future changes to contract agreements to ensure optimal, data-driven payment arrangements.
Audit payment accuracy
Validating contract terms ensures that the payments you are receiving are accurate. Our tools monitor compliance to ensure that payments are compliant with contract terms and the latest adjudication logic. This quickly and easily identifies areas of payment variance, and compares actual payment amounts to expected revenue.
By applying the latest reimbursement logic to your data, identifying underpayments is seamless and hassle-free. This automates your effective contract management and recovers lost revenue while providing details for successful appeals to facilitate revenue recovery with contract parties.
Negotiate favorable terms
Using your historical data, contract modeling enables you to project future revenue based on multiple scenarios for contract changes. This insight enables a thorough evaluation of contract performance, offering detail to assess revenue potential for each area of the business.