Payers, providers work toward optimal dataContract management solutions can ease tensions between physicians and payers looking to negotiate based off the “best” data. Janice Young, program director for Health Industry Insights, says a lot of payers are looking for ways to improve contract management, such as automating the process and creating ways to report off contract data. Solutions that allow providers and payers to share the best available data can expedite the negotiation process and improve their relationship, Young says. |
 Contract management solutions can make providers' and payers' lives easier as organizations work toward the goal of negotiating based on the best available data. |
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3 TRENDS TO WATCH
Janice Young, program director for Health Industry Insights, sees the following trends shaping the contract management market for 2009:
1.COST EFFICIENCY : Automation creates process efficiency and reduces contract cycle times, and can also bring all data surrounding a contract process into a "single source of truth" environment. 2.BEST DATA SHARING : "When health plans go out to negotiate new contracts, they have different data than the providers do, and whether there were overpayments, underpayments, etc. can make negotiations pretty tough," Young notes. Contract management solutions are increasingly allowing both payers and providers to phase out providers' outsourced billing services, which may not have the "best" data available. 3.PAYING AGAINST TERMS : Many health plans have manual processes, and these resource-intensive methods result in inefficiencies, Young says. Integrated uploads of contract terms can decrease inefficient and incorrect payments against those terms. |
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VENDOR SHOWCASE |
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Ariba - Ariba Contract Management |
Concuity - ClearContracts
Concuity's ClearContracts, enables healthcare providers to enhance their bottom line and overall financial profitability and month end processes through technology and service. Concuity provides quick control and visibility over payer reimbursement performance and contracts, enabling providers to immediately recover lost revenue due to underpaid and denied claims as well as unprofitable contracts. Concuity's leading revenue management software delivers a 100 percent Web-based, highly scalable solution that is used by hospitals and health systems across the country. |
Emptoris - Emptoris Contract Management
Emptoris Contract Management is the healthcare industry’s most comprehensive contract management solution, providing powerful contract administration, corporate visibility and proven controls that improve the management of provider agreements, dramatically reduce costs and ensure regulatory compliance. Emptoris customers include the industry’s largest healthcare payers representing 40 percent of the covered lives in the U.S. |
| I-many - I-many Contract Manager
I-many Contract Manager allows organizations to automate the entire contract management continuum from create, store and manage to alerts and notifications on key business events and milestones. |
McKesson - Pathways Contract Management
Pathways Contract Management automates the contracting and reimbursement process, including monitoring payments from payers, updating accounts receivable and performing "what-if" contract modeling analyses across all payers to strengthen contract negotiations. Contract and claim details can also be used for providing estimated out-of-pocket costs. |
MedAssets - MedAssets Contract Manager
MedAssets' Contract Manager is a Web-based revenue management solution designed to help hospitals and healthcare systems accurately forecast, calculate and capture all net revenue contractually owed to them. Contract Manager helps manage contract inventories, leverage historical data in contract negotiations and simplify the reimbursement process. |
| MediTract - TractManager
MediTract is the leading contract management service provider helping healthcare professionals regain control of their contracts and reduce the cost of doing business by providing the tools necessary to improve management's visibility of contractual obligations, enhance compliance and streamline workflow. |
Medical Present Value - MPV Contract Management
MPV Contract Management enables medical groups to evaluate overall payer contract performance, verify reimbursement and assess the financial implications of new and proposed contracts so they can improve financial performance and recover revenue that is lost to contractually underpaid claims. |
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User Reviews |
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"Because our physicians also teach and some conduct research, we could have many contracts for each individual - one for clinical trials, one for teaching services and one for general employment, just to name a few. With so many physicians, it was hard to track just where those agreements were located." |
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| "Underpayments that, most likely, would have otherwise continued for the life of the contract. By addressing those ingrained patterns, we’ve virtually eliminated the downstream impact of those consistent losses compounded over multi-year periods." Georganna Price, manager of payer relations, Ohio State University Physicians. |
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| "Within nine months of implementing MedAssets’ Contract Manager, we identified more than $5 million in carve outs that might have otherwise gone uncollected." Bob Perry, director of patient financial services, Cooper University Hospital, Camden, N.J. |
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