Contract Management

Contract Management is included at no extra cost in all HealthFusion^® Practice Management System installations.

The revenue cycle starts with understanding and interpreting what your providers agreed to accept as payment for a service by an insurance payer.

Key Benefits:

• HealthFusion's Contract Management feature converts the rate you agreed to accept as payment to usable data.
• Payer contracts have become progressively more intricate and benefit from computerized management.
• Complex compensation terms and formulas now require state-of-the-art software to convert those terms to an easy-to-use fee schedule (see the related Medicare formula below).

An Example of Contract Complexity: Medicare's Current Non-Facility Fee Calculation Formula:

2009 Non-Facility Pricing Amount =

[(Work RVU * Work GPCI) +

(Transitioned Non-Facility PE RVU * PE GPCI) +

(MP RVU * MP GPCI)] * Conversion Factor (CF)

At the core of HealthFusion's Contract Management is a sophisticated calculation engine that applies predictable payment rules to procedure codes and provider demographic data. Now, it is easy to determine what your compensation should be for each of the 14,000-plus possible procedures.

HealthFusion's Contract Management assists you in easily transferring your contract terms to a format that can be integrated into a payer-specific fee schedule.