Those who follow CostFlex progress and activities know that we have released white papers and assisted many organizations with a comprehensive look at their business reimbursement agreements.
It’s interesting to see how many payer liaisons agree to discounted contracts and modifications to contracts proposed by payers – without knowing the true financial impact of the agreements they are signing.
Only by adding the accurate cost data to the equations can an analyst make educated profitability assessments of proposed contract terms.
Although combining payer contract automation findings and cost determination data can be a daunting task, it can be generally explained using simplified scenarios. In an example, we will assume your hospital provides a service 100 times a month on average for a certain payer population and your reimbursement agreement provides $1000 payment for each instance serviced. Now let us assume that you added the calculated cost of the service to the analytics and the average cost was $2000 for each patient serviced. You would easily identify the consistent loss occurring and, if you had this information available at the time of payer negotiation, you would have adjusted the payer agreement at the time of proposal.
CostFlex has been providing this invaluable combination of cost and reimbursement information for our clients for three decades. Our Contracts Analyzer software automates 100% of payers in a single interface and our cost data is at the highest level of available accuracy.
Speak to a CostFlex representative today to discover how we can fill the gaps in your performance data.
