The Health Alliance Plan has standardized, automated and streamlined its hospital provider contracting with new technology.
The health plan purchased McKesson's Contract Symphony, a suite of collaborative contract risk management tools. The software improves the contracting for the plan's providers by increasing the transparency of reimbursement terms and boosting the efficiency of the contracting process.
"For almost 10 years we've contracted with McKesson for products to improve the way we work with our provider network and 530,000 members," said Laura Eory, vice president of provider development for the Detroit-based health plan. "Now we've taken the next step by implementing Contract Symphony."
Eory said the health plan went live in less than four months, and she expects positive effects on administrative efforts, sign-off turn-around times, accuracy of reimbursement configurations and the time it takes to maintain reports across contracts.
Healthcare professionals face many challenges in creating, managing and interpreting provider network contracts due to the diverse and complex requirements of both providers and health plans.
McKesson executives say Contract Symphony gives network managers the ability to set accurate expectations in their negotiations with providers through an internal feedback and approval process that expedites understanding and interpretation.
The Health Alliance Plan implemented Contract Symphony to assist in making accurate payments to hospital providers and increase the internal and external transparency of the contracting process.
The plan also contracts with McKesson for claims performance and disease management solutions. The organization is now beta testing the new advanced Contract Symphony Modeling module that would allow it to calculate the immediate costs of contracts under a variety of different scenarios.
"Contracting is a core element in claims management and it has a major impact on the process as a whole," said Carolyn Wukitch, senior vice president of business operations for McKesson Health Solutions. "We felt it was important to develop Contract Symphony as we saw a need for a contracting solution that would allow for quicker and easier communication about contract terms and conditions."