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A survey by Black Book Market Research estimated that healthcare organizations spend $157 billion on manual contract management each year. In the same study, almost all of the respondents (96%) reported using an outdated or completely manual process. This presents healthcare facilities with an ideal opportunity for revenue cycle optimization through adapted insurance contract management.
But while larger provider organizations might have access to bullpens of sourcing experts, teams of industry-savvy negotiators, and custom-tailored contract management software, it may come down to two or three individuals working to provide the same value and quality of patient care on a shoestring budget in the front offices of smaller, community hospitals.
MEDHOST Revenue Cycle Management empowers your business office services by becoming an extension of your existing team. Our experts truly understand the challenges our clients face in an ever-changing healthcare environment. Comprised of patient financial and health information management professionals, we can supplement your hospital's business office services team, assisting with everything from billing to cash posting to effective contract management and account follow-up.
Here are five ways the MEDHOST Contract Management solution supports your business office services:
Our Contract Management team will build and maintain expertly negotiated payer contract terms within MEDHOST Enterprise Solutions as well as provide ongoing maintenance.
Once the insurance contracts are built and attached to the correct plans within the enterprise system, the identification and recovery of insurance underpayments, as well as overpayments, can begin.
This is revenue that you might not even realize is missing, and it can amount to thousands or even tens of thousands of dollars every month.
Our Contract Management team will identify and address trends in billing errors and systemic insurance payor issues via variance reports, then notify you of any issues hindering the accurate calculation of expected reimbursement.
During this step, MEDHOST will work alongside you to collect unpaid reimbursements from insurance companies.
Over the last year, we collaborated with our community hospitals to identify and recover over $4.9 million in revenue that was either not paid, or underpaid.
Months or even years after an insurance company overpays, they may ask for that money back. In some instances, they will automatically withhold the amount from current payments, creating a sudden disruption of revenue.
We can help you to be prepared by identifying overpaid claims before they become a problem.
Our Contract Management team will have a bird’s eye view that allows them to identify the root cause of insurance underpayment or denials and the actions taken to recover missing revenue.
We will communicate this information to your team and work with you to identify underpayment variance trends, understand insurance policies, and anticipate where issues may arise in the future.
Facilitate accurate reimbursements through automated contract lifecycle management, calculate and reconcile expected payments for more effective communications with the insurance carrier, save time and reduce risk.
To learn more about how MEDHOST can support contract management, contact us at 1.800.383.6278 or email inquiries@medhost.com.
