Contract Research

At FinThrive, all hard-copy contracts are scanned, saved as PDF files, and linked to the Internet. Each contract is book marked and labeled with stamps where the rates, effective dates, terms, and renewal dates appear in the contract.

These bookmarks and stamps make it easier for FinThrive personnel to find the pertinent information in a contract when they are analyzing it and loading it into the system. They also help customers as they review the contract profile to make sure that the system definitions accurately reflect the contract terms and conditions.

A contract profile is an electronic version of the paper contract/proposal that contains terms and conditions. The contract profile makes it clear how FinThrive defines contract service types and calculates reimbursement rates. The online profile allows you to see the contract name, effective date and service type definitions for each reimbursement type. Within the contract profile, you can drill down to more complete service type definitions and other details such as the DRG, ASC, CPT and other lookup tables.

A contract profile’s Terms and Conditions (TAC) section contains service types and reimbursement terms as specified by the contract/proposal. These definitions are entered into Contract Manager sing common contract terms, system terminology and mathematical expressions, which are used to calculate expected reimbursement.

The contract profile is divided into four major TAC sections:

• Exclusions – the service types for which there is no reimbursement.
• Pass-Throughs – the service types for which there is additional or conditional reimbursement.
• Reimbursements – the standard reimbursement terms for different service types.
• Stop Loss – special terms that either limit the total reimbursement (stop-cap) or protect the provider from loss (stop-loss).

The Contract Modeling File Download tool allows you to gather information from Contract Manager, compressing it into a file that you can download to your computer. You can later enter it in Contract Modeling for contract modeling and analysis. This information, which includes facility and patient data, provides support for important tasks, specifically negotiating future contracts.

The Contract Modeling File Download page automatically deletes the source files created for you to download when one of the following occurs:

• You exit the page.
• You cancel the process.
• You leave the page idle. In this situation, the records are deleted just before your session expires.

You cannot return to the page later to download the files without rebuilding them.

Do not run more than one session of the Contract Modeling File Download page at one time. Doing so causes one set of records to be overwritten by another.