Network Development

The Network Development Module is designed to assist with network contracting functions.  The ease of contract administration allows for in-depth review of important information relating to provider paneling, variable contract rate structure based on payor source, provider class and credentials.  With access to this important information, a company has unlimited ability to satisfy client care requirements.  The many powerful features of this module will provide a company with valuable information for daily business functions.

Administrative Benefits:

• Contract management:
  • Develop and maintain provider networks
  • Perform contract negotiation
  • Structure in or out of network agreements
• Provider profiling
  • Initiate credentialing
  • Document areas of expertise
  • Develop provider ratings
  • Search for appropriate provider using pre-defined criteria
• Standard online reports

Clinical Benefits:

• Monitor credentials

• Monitor client satisfaction rating

• Review provider paneling requirement during treatment planning

Reimbursement Benefits:

• Manage multiple rate schedules by:
  • Payors
  • Services
  • Provider class
  • Company/Location
• Manage sub-contracted provider reimbursements
• Bill authorized services
• Optimize rate of reimbursement
• Monitor coordination of benefits
• Track information necessary for resubmission and appeals