MANAGED CARE CONTRACT MATRIX

Now you can quickly access and view all your managed care contracts (including fee schedules and DOFRs) online. You can either view the entire actual documents in Portable Document Format (PDF) and/or view a modeled summary outlining the key payment terms of the contract. Our expert contract analysts will translate, then transform all your contracts (even the most complex) into an intuitively easy to read summary format. Furthermore, our 'Quick Search' feature allows you to quickly price claims simply by entering a few billing codes from a UB-04 or HCFA 1500.  Instantly determine how a claim should be contractually paid for each managed care patient. Easily and accurately calculate 'Stoploss' (1st & 2nd dollar, Blue Cross-CA, etc.) reimbursement with our online calculators.  Eliminate the communication breakdowns between the Contracting, Patient Accounting, and other departments.

 

 
Problem   Solution

Today’s managed care contracts are designed by actuaries or attorneys and are often filled with complex payment methodologies and exclusionary clauses that make it difficult to verify claims payment accuracy.  Since various individuals and departments within an organization need to access these contracts regularly, multiple copies of these contracts are often made and stored in physical file folders or computer file folders. Some organizations even create their own summary matrix. The problem with this is that updates are not effectively distributed and matrices do not include detail information often needed.  This can lead to inaccuracies in verifying claims payments or contractual interpretations.

 

Binder One’s Managed Care Contract Matrix is a web based application developed by healthcare professionals to streamline the process of distribution, viewing and pricing of complex managed care contracts.  We create a secure central repository of contracts for designated individuals within an organization to access. Clients can instantly view an actual contract in Portable Document Format (PDF) as well as a modeled summary outlining the key payment terms of the contract.  Since we model the payment terms for each contract at the billing code level, clients can accurately determine payment for any managed care patient by simply entering the billing codes from a UB-04 or HCFA 1500.



Key Features:

Search – Quickly search by Facility, Plan, Product and/or in-house contract codes.  We load your contracts using character recognition software to allow for full-text searches within your contracts.  We bookmark your key terms.

Contract Status – Easily identify contractual history and expiration dates.

Flexible Reports – Compare contracts with one another. For example, instantly compare the ICU rates for all HMO plans.

Calculators – Easily calculate Stop Loss (1st & 2nd dollar) reimbursement with our online calculators.

Security – 256-bit SSL Certification. Encrypted passwords.  Hierarchical password system with multi-level access.

Customer Service – We continually strive to quickly respond to our client’s requests and needs. It is our top priority to provide prompt resolution.

Resource Library - Links to payers, coding sites, various tables/lists (i.e. High Cost Drug Names)

Benefits:

Minimal Training – Our application is so simple and intuitive that users are proficient in less than an hour.

Document Storage/Backup – Serves as the secondary offsite storage for all your contracts.

Contract Compliance Tracking – Stay compliant by easily tracking specific contact requirements (i.e. Stark II or HIPAA). 

Minimizes Employee Turnover – Easily replace an individual responsible for contracts with a new one to prevent lapse in contract management.

Web-Based – Access your contracts anywhere internet is available.

Quick Start Up – We provide experienced contract analyst to quickly load all your contracts. NO hardware, NO software, NO system interface required! WE MAINTAIN AND MODEL ALL YOUR CONTRACTS