Contract for Health Systems and Health Plans


Situation

ContractThe healthcare landscape is confronting unprecedented change, evolving regulatory demands, mounting financial pressures, emerging new care delivery models, and unrelenting competition to deliver the highest quality of care to patients and contracted members. In response, health systems are launching a dizzying arraying of strategic initiatives including ACOs, hospital-based health plans, and high-performing physician networks. To succeed within this complex and ever-changing environment, standardized tools to manage your payer, provider, and facility contracts are essential to survive and thrive.

Solution

There has not been a solution in the market space to keep pace with these requirements… until now! Verity Contract provides a single-source, electronic repository of contracts to standardize, automate, and streamline the contract lifecycle for your payers, providers, and facilities. Contract provides the ability to seamlessly leverage validated credentialing and enrollment data, eliminate duplication across the healthcare continuum, and decrease the administrative burden to manage contract initiation, changes, and renewal.

Key Benefits

  • Improve and expedite the contracting process by decreasing the turnaround time through a more automated execution process.
  • Reduce administrative cost with workflow automation that extends from contract initiation through the review and execution.
  • Stay compliant with the ability to update patient/member directory websites real time with changes, additions, deletions.
  • Enhanced provider experience with tools to support tracking and managing issues, complaints and correspondence. 
  • Provides a library of customizable contract templates to support optimal deployment of contracts and complex contractual arrangements.
  • Increased visibility of delegation agreements with tools to assist with the ongoing oversight and audit requirements. 

 

Features

  • Support desired data hierarchy of Contract → Locations → Participating Providers.
  • Manage various types of contracts from the Health Plan (exclusive agreements, pay for performance, provider services) perspective as well as provider contracts with the Organization (i.e. employment, medical directorship).
  • Access library of contract templates with ability to configure their own templates.
  • Manage fees schedules, reimbursement/compensation types, outliers, and carve outs.
  • Deliver delegation oversight tools to track what agreements are in place and the various requirements for each agreement.
  • Leverage configurable workflows that extend from contract initiation through execution and continuous maintenance.
  • Enhance provider experience with tools to support tracking and managing issues, complaints and correspondence. 
  • Utilize electronic audit functions to ensure compliance with regulatory bodies.

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