New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process. An oversight at any stage of the contract lifecycle can result in non-compliance and financial penalties.
Healthcare payer organizations require tools to create and manage value-based contracts with providers so they can ensure transparency and uninterrupted care delivery to their members. We offer you a unified platform to fast track your overall contracting process. Leveraging our platform, you can manage the length and breadth of a contract lifecycle from initiation, negotiation, execution, archival, amendments, to renewals.
Automate and control contract creation across processes, from start to finish. With the system’s interview-based contracting capability, leverage an intelligent questionnaire to generate contracts with pre-defined templates
Manage provider credentialing in a sequential and organized manner. Retrieve data and documents from CAQH and other credentialing systems. Auto-route cases and provide pre-configured, intuitive checklist to avoid slip-ups
Receive timely and relevant communications via event based triggers. The communications include issuance of welcome, termination and denial letters. Follow-up with providers in case of exceptions, discrepancies and maintain a track of call logs, sites notes, and other issues
Leverage comprehensive capabilities to integrate the system with core claims, credentialing, provider networking and other 3rd party systems. Pull data from third-party systems via out-of-the-box APIs, allowing seamless exchange of data across systems. The system allows XML based API, Web service API and Java beans over XML level API integrations with various 3rd party systems
Create and configure contracts, productivity, ageing, inventory, case discard and geo access reports by leveraging extensive dashboards. Download reports in different formats, such as xls, pdf, and csv, etc. Capture audit trails, maintain notes and decision history to be in compliance with rules and regulations
Enhanced Operational Efficiency
Ensure centralized archival of contract data and documents. Eliminate printing, storage, shipping, and other administrative costs, resulting in enhanced operational efficiency
Improved Process Visibility
Track complete contract cases and manage SLAs. Monitor cases at all levels and maintain audit history, thereby enhancing overall visibility across the board
Eliminate manual handoffs to reduce data entry errors. Avoid misplacement of documents and minimize the overall process turnaround times
Witness continuous monitoring of contract milestones and deadlines. Overcome process bottlenecks; get detailed case records and ensure compliance with rules and regulations
Witness easy accessibility of contracts by leveraging role-based user access to a centralized repository
Expedite contracts with parallel editing, bind variables, reusable clauses & templates and make the overall contracting process much faster