Health Care Contract Management and Modeling Solutions

Advanced contract management functions and episode-of-care analytics are capable of benefiting hospital systems in several ways:

  1. Accurate forecasting of revenue based on complex medical contract terms
  2. Identifying of systemic payor issues
  3. Ability to negotiate more favorable contracts that protect long-term revenue
  4. Identification of underpayments to recover lost revenue and resolve recurring issues

nThrive Contract Management and Modeling Solutions are designed to monitor complex commercial payor contracts and capture all rightfully-earned revenue. When integrated with the entire line of nThrive solutions, health systems benefit from accurate patient bill estimates based on a common contract database as well as automated claim submission, reduced denials and reduced underpayments. nThrive’s Contract Management Solutions have consistently ranked #1 by KLAS* since 2006 and are utilized by nearly 200 health systems. We deliver:

  • 5-10x return on investment based on historical client performance
  • Improved recovery due to accurate underpayment identification
  • Complete government coverage, including Medicare, TRICARE, Medicaid and Workers’ Compensation
  • Risk mitigation in the transition to fee-for-value with more transparency and support for more than 110 defined episodes
  • Contract modeling capabilities to project expected profitability
  • Improved bundled payment and at-risk payor contract performance
  • Root cause identification through contract trending over service month for contract performance setbacks
  • Streamlined access to key metrics, including yield percentage (actual to expected) and payment variance percentage (variance to expected) by contract for trending over service month
  • Macro-level performance monitoring of entire contract portfolio using metrics such as average days to pay, expected payment and patient responsibility
  • Improved revenue streams by means of contract performance analysis as well as identify possible service line additions
  • Multi-facility analysis to pinpoint and segment care improvement needs by single facility or custom facility groupings

© 2015 KLAS Enterprises, LLC. All rights reserved. "2014 Best in KLAS: Software and Services Report." January 2015. "2013 Best in KLAS: Software and Services Report," January 2014. "2012 Best in KLAS: Software and Services Report," Dec. 2012. "2011 Best in KLAS: Software and Services Report," Dec. 2011. "Transcription Services: Competition, Technology, Consolidation," Nov., 2010. "Transcription Services: Steady Demand in a Volatile Market," Nov. 2009.

Healthcare Contract Management Case Study

Kettering Health Network Case Study

Kettering Health Network partners with nThrive to capture 50 percent more patient underpayments with improved health care contract management software

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Medical Contract Management Case Study

Duke University Health System Case Study

Duke University Health System and nThrive automate contract management processes to collect $90+ million in payor underpayments

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