Optimize Payer Contract Performance
Payer contracts get more complex every day, increasing the likelihood that healthcare organizations will be underpaid for many of the services they provide.
MPV Contract Management puts healthcare providers back in control of their revenue cycle and helps them to recover the estimated $1.5 billion in revenue that is lost annually to contractually underpaid claims.1 By leveraging the latest contract terms, payment rules and adjudication logic, MPV Contract Management enables users to accurately price healthcare claims, verify reimbursement accuracy, conduct contract-based appeals and evaluate overall payer contract performance, leading to greater efficiency, improved cash flow and a healthier bottom line.
In addition to monitoring payer compliance with contract terms, MPV Contract Analysis gives users the ability to assess the financial implications of new and proposed contract terms right down to how much an individual provider could gain or lose. With this information at their fingertips, healthcare providers can target their negotiation strategies to the factors that affect reimbursement the most and also assess the potential introduction of new lines of business.
Additional benefits include:
- Increased revenue through underpayment recovery
- Higher contract rates
- Improved tracking of chargemaster accuracy
- Quicker payment
- Lower billing and contract administration costs
- Fewer registration, coding and posting errors
MPV Contract Management ASC
Designed specifically for ambulatory surgical centers (ASC), MPV Contract Management ASC provides a powerful technology platform for managing complex ASC contracts and reimbursement models. By leveraging advanced claims valuation logic within MPV Contract Management, this comprehensive solution processes each claim in accordance with the correct ASC contract. Then, after examining CPT codes associated with specific surgery groupers and exceptions, MPV Contract Management ASC maps each item to the appropriate payment rates for accurate claims valuation. As a result, ASCs are able to capture accurate reimbursement as well as identify and appeal underpayments from commercial payers based on the latest contract terms, payment rules and payer adjudication logic.
