Jessica Marple from PeaceHealth Medical Group discusses how they improved payer relationships and reached a return on investment of $3.8 million over 5 years with Contract Manager.
Perform contract auditing and analysis to gain visibility into payer contract reimbursements and performance. Confidently report and negotiate new payer agreements.
Unfortunately, missed payer payments and underpayments happen. Identifying and correcting these inaccurate payments often falls to healthcare providers. These errors can cause stress and volatility to your revenue cycle.
Simple human error is the main reason why medical claims are denied. The smallest typo or discrepancy can lead to an immediate denial, and reworking a claim rarely increases its chance of being more accurate. Streamline claims management by checking that every claim is clean and error-free before it is submitted. Fewer denials and reworked claims mean a faster and more predictable revenue cycle, as well as lower administrative costs and more time for staff to focus on patient care.
You need automated access to the right data. Our solutions help you get reimbursed accurately and quickly, while strengthening your relationships with payers.
Scripps Clinic client success story
Learn how $10.6 million in underpayments was recovered in 9 years.
Validate reimbursement accuracy
Recover underpayments
Manage and execute appeals
Manage claims status
Evaluate contract results
Negotiate favorable terms with payers
Streamline and simplify workflow processes
Contact our team to get started
Automated Healthcare Payer Alerts
Avoid payment delays and lost revenue with automated payer policy and procedure change notifications.
Contract Manager and Analysis
Audit payer contract performance to assure compliance—and maximize revenue.
More information about Experian Contract Manager
Hospitals & Health Systems
- Powerful multi-payer claims valuation engine so every claim is priced on your terms
- Valuation is performed at the claim level, considering rules such as stop-loss, case rates, carve-outs and multiple grouper methodologies
- Monitor reimbursement using online dashboards and reports
Medical Groups
- Our team of contract analysts defines and maintains your contract terms, fee schedules, carve-outs and payment policies
- Reimbursement is monitored without involving IT thanks to online dashboards and reports
- Payment discrepancies are reduced with Power Reporting, which provides revenue cycle intelligence and interactive graphs
Duke Private Diagnostic Clinic partners with Experian to evaluate contacts and ensure they are being paid appropriately. They can now identify system issues that could result in underpayments.
The University of Iowa Hospitals & Clinics saved time and money implementing a contract management system that allows them to monitor payer compliance and audit remittances based on latest payment rules and adjudication logic.
The secret to decoding insurance payments and contracts
Keeping up with payer alerts
Collect every dollar due
Validated by Experian Data Quality
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