Maintain Contract Profiles

The Contract Profile Maintenance page allows you to view, add, update and delete records that exist in the system’s Contract Profile table.

Create a New Contract and Contract Profile

Use this procedure to create a new contract not previously in the system. For information on the standard procedure of creating a new contract, refer to Add a Contract Profile.

Procedure

To access the Contract Profile Maintenance page, select Go To > Contract Maintenance > Contract Profile Maintenance.
In the upper Contract section of the page, specify the criteria for the new contract you want to add.
In the Contract Profile section, specify the criteria for the contract profile you want associated with the new profile.

For more information about the specific fields on this page, refer to the Field Descriptions table below.

Click Add Contract Profile and Contract. The Add was successful! message appears.
Optionally, you can perform any of the following tasks while on this page:
- Add a new contract and profile using the procedure outlined above.
- Edit an existing contract and profile and click Update Contract to save the changes.
- Click Delete Contract to remove the current contract.
- Click Edit Contract Document to make changes to the associated contract document. For more information, refer to View or Edit a Contract Document.
- Click View Master Document Image to see the contract document image. For more information, refer to View a Contract Image or Rate Image.
- Click Edit Contract Image(s) to modify the contract images associated with the contract document. For more information, refer to Edit a Contract Image.
- Click View Rate Image(s) to view the rates for the contract. For more information, refer to View a Contract Image or Rate Image.
- Associate another profile with the new contract. For more information, refer to Add a Contract Profile to an Existing Contract.
- Make changes to an existing contract profile record. For more information, refer to View or Edit a Contract Profile.
Some data is not editable for a contract profile in Active Status.
- Click Delete Contract Profile to remove the contract profile from the contract. For more information, refer to Delete a Contract Profile.
- Click Reset to delete all the data and return a blank page and start over. Any populated fields or results lists are lost when you click Reset.

All of these procedures may be performed in greater detail from the Contract Profile Management page in the Contract Loading menu, for those facilities for which it is available. For more information, refer to Contract Loading.

Add a Contract Profile to an Existing Contract

Use this procedure to add contract profiles to existing contracts.

Procedure

To access the Contract Profile Maintenance page, select Go To > Contract Maintenance > Contract Profile Maintenance.
In the Contract drop down list, select the contract to which you want to add a profile.

If you are uncertain about which contract you need to add a contract profile:

Type the appropriate selection criteria in one or more fields in the Contract section and click Display Contracts. The Contract Profile Maintenance page lists all the contract documents that meet your criteria.

If you leave the selection criteria fields blank, the search will return records for every contract in the system.

Click a link in the Company column to load that contract record into the fields for editing.

Select Add New Contract Profile in the Contract Profile drop down list.
Type the data for the new contract profile in the Contract Profile fields, and then click Add Contract Profile to add the new contract record to the system. The Add was successful! message appears.

For more information about the specific fields on this page, refer to the Field Descriptions table below.

Optionally, you can perform any of the following tasks while on this page:
- Add a new contract and profile. For more information, refer to Create a New Contract and Contract Profile.
- Edit another existing contract and profile, as outlined in the above procedure.
- Click Delete Contract to remove the current contract.
- Click Edit Contract Document to make changes to the associated contract document. For more information, refer to View or Edit a Contract Document.
- Click View Master Document Image to see the contract document image. For more information, refer to View a Contract Image or Rate Image.
- Click Edit Contract Image(s) to modify the contract images associated with the contract document. For more information, refer to Edit a Contract Image.
- Click View Rate Image(s) to view the rates for the contract. For more information, refer to View a Contract Image or Rate Image.
- Associate another profile with the new contract. For more information, refer to Add a Contract Profile to an Existing Contract.
- Make changes to an existing contract profile record. For more information, refer to View or Edit a Contract Profile.
Some data is not editable for a contract profile in Active Status.
- Click Delete Contract Profile to remove the contract profile from the contract. For more information, refer to Delete a Contract Profile.
- Click Reset to delete all the data and return a blank page and start over. Any populated fields or results lists are lost when you click Reset.

View or Edit a Contract Profile

Use this view or modify contract profile records in the system.

Procedure

To access the Contract Profile Maintenance page, select Go To > Contract Maintenance > Contract Profile Maintenance.
Select a contract from the Contract drop-down list. The contract information populates the edit fields, including the information for the default contract profile associated with the contract.
Select the appropriate contract profile from the ContractProfile drop-down list. The profile data populates the edit fields.

Some contracts have many contract profiles associated with them; some have only a few, or one.

Review the Contract Profile Maintenance page.
To modify a contract profile, make the appropriate changes in the data fields of the Contract Profile section.
- Some data is not editable for a contract profile in Active Status.
- For more information about the specific fields on this page, refer to the Field Descriptions table below.
Click Update Contract Profile. The Update was successful! message appears.
Optionally, you can perform any of the following tasks while on this page:
- Add a new contract and profile. For more information, refer to Create a New Contract and Contract Profile.
- Edit an existing contract and profile and click Update Contract to save the changes.
- Click Delete Contract to remove the current contract.
- View or edit another contract profile, using the procedure outlined above.
- Click View Master Document Image to see the contract document image. For more information, refer to View a Contract Image or Rate Image.
- Click Edit Contract Image(s) to modify the contract images associated with the contract document. For more information, refer to Edit a Contract Image.
- Click View Rate Image(s) to view the rates for the contract. For more information, refer to View a Contract Image or Rate Image.
- Associate another profile with the new contract. For more information, refer to Add a Contract Profile to an Existing Contract.
- Make changes to an existing contract profile record. For more information, refer to View or Edit a Contract Profile.
Some data is not editable for a contract profile in Active Status.
- Click Delete Contract Profile to remove the contract profile from the contract. For more information, refer to Delete a Contract Profile.
- Click Reset to delete all the data, return a blank page, and start over. Any populated fields or results lists are lost when you click Reset.

Field Descriptions

The following table explains fields on the Contract Profile Maintenance page. For internal users only, the source information is given for some fields, in the format: “Table.Field.” iinventory_coneff_maintenance.asp

Field	Description
Contract
Adjust Mod 50 Line Items	Toggles the Modifier 50 Line Items feature on and off; the default is Off
AR Cutover Claim Type	AR claim type for the write-down transaction
AR Cutover Date	Start date for sending AR write-down transactions Note: You are presented with a notification when the format is entered incorrectly for this field.
AR Cutover Limit Date	Earliest date AR write-down transactions are accepted Note: You are presented with a notification when the format is entered incorrectly for this field.
Company	Insurance company issuing the contract
Contract Name	Complete name of the actual contract
GY Non-Covered Charge Date	Indicates that non-covered GY charges are accepted for this contract. This field is required before you can apply the self-administered drug discount on the Product Maintenance page. For more information, refer to Maintain Products and Product Matches. Note: You are presented with a notification when the format is entered incorrectly for this field.
GZ Non-Covered Charge Date	Indicates that non-covered GZ charges are accepted for this contract. This field is required before you can apply non-covered write-off charges on the Product Maintenance page. For more information, refer to Maintain Products and Product Matches. Note: You are presented with a notification when the format is entered incorrectly for this field.
Manual Adjustment Reversal Date	Setting a date in this field enables the manual adjustment reversal logic to be turned on. This field can only be set to the current date or a date in the future and cannot be edited once it is entered. If the field is left blank the manual adjustment reversal logic is not turned on. Note: You are presented with a notification when the format is entered incorrectly for this field.
Rates Effective By	Indicates the date to use as the effective date for rates on the profile; options include Admit Date, Discharge Date, and Submit Date.
Contract Profile
Active	Indicates if the current profile is Inactive, In Production, In Audit, Client (customer) Deferred or Superseded Note: Once a profile is in production, the active status can only be changed to Client (customer) Deferred.
Administrative Fee	Dollar amount of the administrative fee imposed when a late payment penalty is applied to the account.
Assigned Date	Date assigned for the current implementation stage
Auto Renewal	Indicates whether the profile is automatically renewed
Category/ Complexity	Category of terms for this contract
Claim Type	Type of claim for this contract document
Comment	Additional questions or comments about the contract
Contract Document	Contract document associate with the contract profile
Document Type	Type of document received by FinThrive
Effective Date	Effective date of the current contract rates. Valid format is mm/dd/yyyy. Note: You are presented with a notification when the format is entered incorrectly for this field.
Float Days	Number of days to be added to the Late Days to determine the late payment penalty
ICD Compliance Level	Indicates if a contract profile is ICD-9 or ICD-10 compliant and can filter contract profiles based on compliance. Mixed - Contracts with ICD-9 and ICD-10 codes on the same contract ICD-9 - Contracts with ICD-9 codes only ICD-10 - Contracts with ICD-10 codes only None - Contracts with no ICD codes
Ignore Modifiers on CCI Edits	Option to ignore modifiers when the Correct Coding Initiative (CCI) edits are applied to accounts repriced by the contract profile. This option is only available when the Perform CCI Edits check box is selected. Both the Perform CCI Edits check box and the Ignore Modifiers on CCI Edits check box must be selected to utilize this option.
Implementation Priority	Implementation priority—0 to 999
Implementation Stage	Implementation stage the contract is currently in
Implementation Stage Date	Date the latest stage of implementation was completed
Implementation Status	Status the contract is currently in
Implementation Time Estimate	Implementation time estimate in hours
Inventory Received Date	Date the contract inventory was received by FinThrive. Valid format is mm/dd/yyyy. Note: You are presented with a notification when the format is entered incorrectly for this field.
Late Payment Penalty	Determines the type of late payment penalty to apply to this profile. Options include the following: None - No late payment penalty is applied Interest Percentage - Penalty amount is a specified interest rate applied to each day beyond the late and float days; the annual interest rate is specified in the Late Payment Percentage field Percentage of Billed Charges - Penalty amount is a specified percentage of billed charges; the percentage is specified in the Late Payment Percentage field Billed Charges - Penalty amount is the amount of the billed charges with no discounts applied. Note: Only one late payment penalty type can be applied to a contract profile.
Late Payment Percentage	The percentage used to calculate late payment penalties. For Percentage of Billed Charges penalty types, the value in this field specifies the percentage of billed charges to use as the late payment penalty. For Interest Percentage penalty types, the value in this field specifies the annual interest rate to apply to the days beyond the late and float days. When calculating the penalty, the system calculates the daily compound rate based on the annual rate entered in this field. The daily compound rate is multiplied times the number of days beyond the late days and float days combined and then multiplied times the total expected payment. Example interest percentage calculation: Days to Payment = 65, Late Days = 45, Float Days = 5 or 65 > 50, then 65-50 = 15. Interest % = 10%“1ake Expected Payment 10,000 * (15 * Daily Compound Rate {@ 365} %) = 41.17
Loading Responsibility	Filters the results based on who is responsible for loading the contract: FinThrive Client (customer)
FinThrive Received Date	Date the document was received by FinThrive. Valid format is mm/dd/yyyy. Note: You are presented with a notification when the format is entered incorrectly for this field.
Maximum Appeals	The maximum number of appeals allowed for a claim.
Multiple Primary Payer Logic	Selecting this check box lets you group claims multiple primary payor grouping logic
Perform CCI Edits	Option to apply Correct Coding Initiative (CCI) edits to accounts repriced by the contract profile
Process with Admit Date	Identifies if the Admission Date is used to calculate the LOS for Inpatient claims: Blank - The LOS is determined by the Service From - Service To dates. Inpatient - The LOS is determined by Value Code 80, if present. If Value Code 80 is present on the claim, the LOS is determined using the number of covered days. If Value Code 80 is not present, the LOS is determined using the actual Admit Date and Service To date.
Prod Audit Date	Date of last in-production audit of these terms
Production Date (APP_DATE)	Date the contract went into production
Profile Copy	Indicates if FinThrive Contract Inventory personnel created the contract profile shell based on an existing profile.
Profile State	Identifies the state (AK, AL, AR, and so forth) associated with the profile type. Use this field to distinguish between contracts for Government Programs or Traditional Managed Care plans for different states. Note: This field is active for all profile types.
Profile Type	Identifies contract profiles by type (either for Government Programs or Traditional Managed Care), and helps track departmental workloads by identifying the type of profile.
Prompt Payment Days	The number of days for the payor to submit payment before Late Payment Penalty and Late Payment Percentage take effect.
Rate Image	ID of the scanned rate image file
Set Term date for all previous contract profiles	Check box used to enable termination date to be set for all previous contract profiles when terminating a specific profile. You must select this check box to enable this option. Note: The default for this option (check box) is unselected.
Termination Date	Date the contract is no longer effective or is terminated Note: You are presented with a notification when the format is entered incorrectly for this field.
Termination Notice	Number of days notice required for contract termination
Terms and Conditions File	File name of the terms and conditions document
Timely Filing Days / Appeal Days	The number of days within which the charges must be filed after the patient is discharged. / The number of days given to appeal a claim.
Timely filing limit	Number of days within which the charges must be filed after patient is discharged
Uses OPPS (CarePricer)	Identifies contract profiles that price using the OPPS tool. Note: This option is available to internal users only, and it is used exclusively by members of the CarePricer team.