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Improving Contractual Revenue through Improved Managed Care Compliance

Session #: 81810-xh
Presenter(s): Braden Decker, Henry Ijams
Session Length: 1hr. 45 min.
Event: HFMA 2008 Audio Webcast
Date: 3-24-08

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What is AudioPoint CD?
PowerPoint presentations with session audio built-in, providing a virtual re-creation of the original workshop, for play on any computer using your browser. Simply put the CD into your computer to watch & listen to your workshop.

Revenue cycle management is getting a lot of attention today in the Healthcare industry. Successful revenue cycle management initiatives should include a thorough analysis and understanding of the managed care contract life cycle. When gone unattended, Providers risk losing significant revenue when managed care contractual obligations go unmet. When one considers that each facility is loosing up to 5% of their Net Patient Revenue due to underpayments and denials, within a year, those underpayments could result in a loss of millions of dollars for a mid to large size hospital or large physician group.

In many organizations the process of analyzing and negotiating a contract is not closely linked to actual contract performance, i.e., cash collections. As a result, contract performance is not thoroughly analyzed through out the term of the contract to compare expectations at negotiation to actual collection and payment results. Whats more is that Contract Management and Payment Review (CMPR) systems are getting a lot of attention due to improved technology and proven track records of improving hospital net patient revenue. This webcast will focus on understanding the contract life cycle, including the importance of contract modeling, negotiation strategies, good patient accounting practices, measuring results and compiling the right performance information to use in the next negotiation. This webcast will also address where managed care information gaps occur in an organization and how to over come some of the gaps to improve contract performance.



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