The Managed Care Report Card is a tool that provides an independent, third-party evaluation of your managed care payers to confirm that you are receiving expected reimbursement.
The Report Card will help answer important questions regarding your managed care reimbursement:
- Are similar cases being paid in a consistent manner across payers?
- Are carve-outs being paid appropriately?
- Are there excessive denials?
- Are there unnecessary delays holding up your reimbursement?
- Are your payment levels similar to like providers?
Through a simple data download (common 835/837 files) KA Consulting analyzes your managed care reimbursement activity. The Report Card reviews multiple payers and compares your organization’s billed and paid managed care claims to best practice standards. After the results have been analyzed, we provide a scorecard of your facility’s performance with an explanation of our findings, which also includes areas suggested for further analysis.
The Managed Care Report Card provides the ability to evaluate the health of your managed care reimbursement without having to configure and reconcile a contract management system. It validates your efforts in collecting entitled managed care revenue and identifies areas where your organization can improve. The Report Card can confirm your organization’s success and also can act as a catalyst to help make meaningful change for your managed care reimbursement processes.
