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

NETWORK DEVELOPMENT

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