A contract modeling and claim repricing solution for health plans that want to assess alternative pricing options, monitor contract compliance, and evolve reimbursement strategies.
Identify savings opportunities with increased transparency. Interactive dashboards help you visualize claims costs for a more complete view of the services and providers driving price increases.
Support provider negotiations via a flexible, intuitive user interface. Provider management teams can quickly model proposed contract rates and adapt models based on provider counter-proposals.
Monitor contract and provider performance over time, helping to improve provider compliance and the accuracy of payment processing.
Expand pricing options with integrated third-party rate schedules, such as Medicare fee schedules, that increase available pricing options and improve the accuracy of payment and pricing models.
Automate pricing processes with an integration framework that streamlines the sharing of repricing terms to help reduce your administrative costs and improve pricing accuracy.
Implement innovative payment models and evaluate their performance, supporting the transition to value-based reimbursement.
Contract Modeling with Reimbursement Manager
This solution helps health plans create and manage complex payment methods, supporting the transition to value-based reimbursement.