Hospital underpayments are nearing 100 billion dollars nationally which explains why Executives are taking notice. Every day, hospitals are underpaid at rates which are in variance to their payer contracts. Many of these underpayments go unnoticed making it difficult to recover. At the heart of underpayments is a hospital’s Contract Management System. Whether you are using an existing Contract Management System or looking at a new one, here are some helpful tips to avoid underpayments and false variances:
- Ensure your Contract Management System Vendor loads and maintains all contracts or provides detailed assistance.
- Ask your vendor to describe all payment calculations and repricing capabilities. These include Commercial, Medicare, Medicaid and Managed Care.
- Finally, quantify the number of underpayments that are flagged at time of payments. If your Contract Management System does 80% or less, consult the vendor.