Modeling and Analysis

Modeling and Analysis is a tool for modeling various reimbursement rates in a contract, thereby determining the impact of changing rates or planning future contract negotiations. Benefits of the Modeling and Analysis tool include:

• The ability to make rate changes for quick analysis
• Multiple users can access the same information without special training; i.e., basic updating is easy to learn
• Easy viewing and comparison to current rates vs. proposed rates
• Ability to analyze impact of charge increases
• It identifies only those services with activity
• A good pre-modeling tool to suggest possible strategies
• You can do a quick audit of claims and their interaction to the current contract set-up

Modeling and Analysis offers two views:

• The Patient View helps you decide which service types to model. The payment-to-charge ratio (PCR) is one of the main factors in deciding to model higher rates. It also helps you to determine which service types have a high-volume or high-dollar impact and whether to renegotiate better rates for these services in future contracts.
• The Contract View lets you model the impact of changing reimbursement rates for inpatient or outpatient services. The modeling is not a permanent change; it is not saved when you exit the session, although you can print various models as you work.

How To Topics

The menu on the left provides key concepts and step-by-step instructions that guide you through modeling and analysis.

The following topics provide key concepts and step-by-step instructions that guide you through modeling and analysis.