Truworth recognizes that healthcare provider organizations today are challenged by dynamic cost structures, and increasingly complex contracts and that traditional patient billing and accounting systems cannot correctly handle complex and detailed payer contract terms. Also, most Contract Management systems are either cumbersome or complicated to manage.

The result is that most healthcare providers are consistently underpaid and cannot determine exactly what is owed to them. To improve profitability, they need a solution to effectively monitor contract performance over time and manage these managed care contracts knowledgeably.

 

Our customized solution developed using the best of breed toolsets allows you to accomplish the following:

• Define and set up Contracts that will enable re-imbursement calculations and allow a provider to make accurate timely contractual adjustments at the time of billing.
• Establish amounts due on account.
• Compare Actual payments received to the calculated amount due.
• Ability to take existing contract stipulations and create “what if” scenarios for future contract negotiations. These scenarios can be applied to past contract utilization, so that impact of any changes can be easily analyzed and assists a provider in payer negotiations.
• Provide management reports to monitor variances and collect underpayments