Cost Accounting Manager
Best Practice Manager
Managed care contracts have reimbursement terms and formulas that can be complex, and very difficult to monitor. HCCs Contract Manager gives healthcare organizations the tools to determine exact expected reimbursement and contractual allowances for all payers. Contract Manager tracks and manages an entire patient encounter from preadmission, to levels of care experienced through billing and finally to account resolution. Information is maintained in Contract Manager to enhance the analyses of profitability, utilization, and compliance. With Contract Manager, you can use historical data to forecast the impact of "what if" scenarios and model potential changes in rates, volumes, costs or charges to project gross revenue, contractual allowances, net revenue, total cost and profitability of contract payers and services. HCCs Contract Manager can consistently address these issues resulting in increased cash flow and improved long-term financial health.
- Models complex terms with multi-tiered stop losses, pass throughs, outliers, co-payment amounts, per diems at the case, day of stay or encounter level of detail and many other terms.
- Posts accurate contractual allowances at the time of billing.
- Accurately identifies underpayments to pursue collections confidently.
- Shows payers how reimbursements were calculated and the resulting reimbursement due.
- Automatically recalculates reimbursement and contractual allowance changes caused by updated patient information or by retrospective changes in contract rates and terms.
- Supports all payer reimbursement and contractual allowance calculations, including Medicare APC determination, CHAMPUS and Medicaid.
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