Maximize Your Contract Management to Boost Revenue
Use the Contract Rates Module to Evaluate and Manage Contracts
The Contract Rates Module in the RCS supports evaluation and management of contracts with third-party payers to help your organization get paid. The module includes a set of reports that provide the calculated allowable rate by CPT code and payer/FSC, along with the average calculated allowable rate based on other clinical and academic practice plans in our database.
The Contract Rates Module features four core reports:
- Rates Analysis Summary by CPT
- Contract Portfolio Summary
- Undercharge Report
- Under/Over Payment Report
These reports facilitate a detailed, CPT code-specific understanding of your current third-party payer contracts by payer. They also let you see how your arrangements compare with those of other clinical practice plans so you can find actionable steps through comparative data.
Finally, the Contract Rates Module reports provide information on interdepartmental variability in the impact of individual contracts, helping your organization get together on the same page to eliminate costly discrepancies.
Case Study: CPSC Helps UVM Medical Center Uncover Market Differences
The University of Vermont Medical Center uses the CPSC Contract Rates Module to understand and align faculty compensation with productivity. Since market differences in payments per RVU drive market differences in compensation across specialties, the group chose to manage the plan by comparing the reimbursement in each of its specialties with the average reimbursement rate for all CPSC members.
Learn more about UVM Medical Center’s model and how the group integrated data from the RCS Contract Rates Module.
Case Study: Uncovering Lost Revenue with CPSC Chargemaster Management
One of the biggest blind spots in the clinical practice organization revenue cycle is chargemaster management — namely, ineffective management. The CPSC used our Contract Rates Module Undercharge report to uncover nearly $75,000 in lost annual revenue due to undercharges — and that’s just for one practice plan member.
For another member, the report highlighted more than 50 unique charge amounts for CPT code 99243. Of those, 11 unique charge instances were below the commercial contracted rate and six of these instances were below Medicare rates.
The following Chargemaster Check-up Report uses comparative data from the CPSC RCS to help practices get a deeper understanding of how their charges compare to other nearby academic practices. The report is organized by specialty, provides the charges per CPT code and displays percentile and mean benchmarks using revenue data submitted by other member organizations.