Systemic errors with contract management systems occur for a variety of reasons, such as incorrect proration rules or improper contract amendment updates. Our detailed review allows us to identify these errors in interpretation and programming that cause a hospital’s expected reimbursement calculators to misinterpret complex contract terminology.
Click Here to find out how STAT recovered $400,000 for a hospital in a single year from a computer proration error
STAT’s working knowledge gained through our post-payment review of accounts enables us to compile extensive information about a hospital’s underpayment trends, evaluate reimbursement rates for different service areas, and review the hospital’s managed care contract terminology.
We minimize the risk of future underpayments by assisting with contract interpretation and negotiations with insurance payers. We are able to make recommendations that address each client’s potential underpayment exposure.
Our high-level analysis of account data for an extended time period allows us to identify adverse payment trends which are useful for negotiating stronger payer contracts.