Provider contracting process deals with end to end tracking of provider contracts throughout the contract lifecycle from creation, negotiation, approval, to termination. Healthcare payers process tens of thousands of contracts each year. Each provider contract is stored on paper and managed manually making the process of updating contracts, variance analysis, and compliance audits time-consuming and erroneous.
Challenges Faced:
Newgen’s Provider Contract Management solution enables Payers to securely exchange information both within and outside of the organization; improve operational efficiencies; and provide user visibility into the contract data. The solution integrates with existing critical information systems to facilitate enterprise-wide collaboration, and increases accountability by providing rights-based access at department and user levels.
Solution Highlights
Benefits
Constant innovations in provider reimbursement models although great for transparency and accuracy can become administrative nightmares. They put an increasing burden on administrative processes for healthcare providers and also become one of the provider’s greatest areas of dissatisfaction. However, there is a crying need for greater agility and accuracy, and it’s driving healthcare providers to re-assess and remodel their provider contracting processes and supporting systems. Errors in the process have a significant impact on the medical loss ratio (MLR), administration costs, and patient satisfaction.
A brief on the Provider Contracting Process is explained below:
Advantages of Using a BPM based Automated Solution:
