- Third party payer calculation engine and adjudication system
- Calculate and post contractual allowance and expected reimbursement
- Shadow or replace your existing in-house contract management system
- Correct and supplement your current process
- Appropriate patient registration and payer plan assignment
EXPERIENCE ACCURATE ALLOWANCES AND MONTHLY FINANCIALS!
A third party payer calculation engine and adjudication system, this service includes calculating and posting the accurate contractual allowance and expected reimbursement at the time of final billing.
This service includes all contractually obligated payers; managed care, Blue Cross, Managed Medicare, Managed Medicaid, Traditional Medicare, and Tricare.
The majority of healthcare providers currently utilize a calculation engine (contract management system). MCP’s service compliments, supplements, or replaces your existing processes at your discretion.
MCP begins the process by loading all contractual agreements, scanning, indexing, and profiling all agreements, and calculating the contractual allowance and expected reimbursement at time of final billing. MCP electronically posts the adjustment the day we receive the final bill and any adjusted billings.
A key component to a successful analysis begins with patient registration. MCP verifies the correct payer code assignment at time of final billing ensuring the correct contractual allowance is posted. MCP’s Patient Responsibility Estimator is also included (see our additional Reimbursement Cycle services links).
In addition, MCP attaches the Account Calculation Detail in your patient accounting system, reflecting the expected reimbursement by revenue code as it appears on the bill. MCP attaches the respective actual contractual agreement to each account. These two items allow for easy access and printability.
You can utilize our professional staff of certified public accountants, registered nurses, and accountants, to shadow and adjust your existing contract management system, or we replace your existing system and become the sole service provider.
This is an ideal service to ensure correct net receivables, accurate allowance, and correct monthly financials.
MCP’s fees are a fixed monthly fee.
This service typically includes a retrospective and concurrent underpayment and recovery analysis. You may also incorporate contract modeling.
We have 2 questions:
- Would you like to experience accurate allowances and monthly financials?
- Would you like to eliminate or reassign patient accounting staff FTE’s?