Reimbursement Management Contract Maintenance
Maintaining the ever-changing contract setup to ensure accurate reimbursement and contractual calculations can be a strain in any organization, especially when resource availability is limited. Outsourcing these maintenance tasks is an alternative CCC is ready to assist with. We provide business experts who specialize with the Reimbursement Management application and have knowledge in the aspects of government regulation, managed care methodology, commercial and private pay contract arrangements. Our expertise in the technical mechanics of building contracts and maintaining the Reimbursement Management system will assist in the accurate management of payments and receivables.
We currently have several full maintenance arrangements with MedSeries4® clients in multiple states as well as assist in project capacity for specific requests. Combinatorics Consulting Company can provide expertise in the following areas:
- Administer all aspects of contract definition and entry to the MedSeries4® Reimbursement and CaseMix applications.
- Assist in development of revenue recovery procedures utilizing tools of the Reimbursement Management application.
- Audit and report payment discrepancies on monthly or quarterly interval.
- Produce and deliver reimbursement and payment reports, as requested, utilizing standard application reporting features and IBM i Query/400®.
- Provide pertinent patient and service mix detail relevant to contract re-negotiation.
- Assist in the implementation of RE and DG application releases containing application changes and regulatory compliance.