MD Clarity ensures providers are fully-equipped with advanced analytics for contract negotiations by combining a Scenario Modeling Engine with a Data Warehouse of your historical billing, transaction, cost, and clinical data to project the impact of changing insurance agreements. You will be able to simulate proposed fee-for-service contracts, new payment methodologies, or population health scenarios and see the quantitative impact of rate changes based on the unique mix of services your healthcare system offers.
Our customers have the unprecedented power of quickly comparing how all of their contracted payers will adjudicate any combination of services. For example, if you want to know how a private insurance company you are contracted with stacks up against Medicare when it comes to a particular set of diagnostic imaging or laboratory services, you can have these metrics presented graphically and tabularly in a matter of seconds.
Manually and accurately analyzing proposed insurance contracts is often a time-consuming exercise. Insurers present deals which are said to be year-over-year improvements, but when considering your organization’s patient mix, Medicare RVU, DRG and APC-related changes, market forces, complex payer rules, changing payer guidelines, and past payment performance, that simply may not be the case.
Using your healthcare organization’s historical data and all variables that impact contract performance, you need a way to rapidly build and run scenarios to ensure you are effectively negotiating the best deal. MD Clarity enables this. You can now engage in systematic, data-driven negotiating that exceeds the capabilities of insurers.