RevolutionSoftware for Healthcare Contracting
It’s the only software of its kind designed to help you easily and conveniently access the same kinds of data and information that payers are looking at in negotiations. RevolutionSoftware is the tool to help you increase your revenues by providing analyses to help you analyze your business operations, payer contracts, and more.
Revolution Software Benefits:
1. RevolutionSoftware is the only software tool that focuses on provider contracting analytics. It’s designed to maximize your provider reimbursements.
2. RevolutionSoftware is the only web-based tool to benchmark and analyze reimbursements by CPT code.
3. RevolutionSoftware enables you to compare fee schedules and calculate revenue differences based on volume between different payers. This is key to determining if you are being under-reimbursed for the same CPT code from one payer to another.
4. RevolutionSoftware allows you to readily identify your top codes based on volumes and contracted rates and enables out-of-network and chargemaster modeling.
5. RevolutionSoftware is an easy and practice way to ensure your actual payments equal contracted rates from a payer.
6. RevolutionSoftware is Internet-based — it can be accessed from anywhere with an Internet connection. There is no software to install and you can log on from anywhere at any time.
RevolutionSoftware is a fantastic complement to your billing system to ensure you have the information and analyses to get paid at the highest possible contracted rates on your commercial payer contracts.
Key Features of Healthcents RevolutionSoftware:
- Payer Rate Analysis: Compares your rates by CPT code to what other providers are receiving from payers for your same CPT codes in your Medicare locality, in your state, and across the USA*. Also provides your rates as a percentage of Medicare in your Medicare locality.
- Payer Comparisons and Claims Analysis
- Compares any two payer fee schedules against consistent volumes to determine if any codes need to be moved up
- Compares a sample of your claims payments to your payer contracted rates to determine possible under-reimbursement
- Business Models:
- Out-of-Network Modeler: Helps you model and compare your current and projected contracted rates in a payer’s network vs. out-of-network
- Bill Charge Modeler: Helps you to manage your chargemaster rates to ensure that bill charges are set at reasonable levels (UCR) for both your in-network and cash-paying patients
- Repository: A place to store all of your fee schedules related to payer contracts, online, in one easy to find and secure location.
- Other Key Benefits:
- RevolutionSoftware is the only known tool that automates the analysis of provider health insurance contracts
- Supports physician and ASC agreements
- Completely web-based:
- Log on from anywhere, any time
- No software to install
- All that is needed to run the tool is a web browser and Internet connection
* Data provided where available.