Contract/Claims Management Analysis

CMA – Contract/Claims Management Analysis system allows users to manage claims, contracts and revenues across all operating units to re-engineer claims processing and increase collections. Use the contract management system to calculate an accurate expected payment for Managed Care, Medicare, and Medicaid contracts and pass contractual allowance data to the client’s patient accounting system. With CMA, the end user can display the results on the screen, print reports or fully update the system with final contracts. Kreg has developed Medicare contract update services, retrospective payment reviews and maintaining/validating all contracts as value added services for the user.

CMA is a complete managed care modeling and payment compliance tool. Its functions include calculating accurate expected payments, managed care contract negotiations and estimating third party contractual allowances. In addition, CMA allows the user to track and analyze Medicare APCs, as well as model APCs for the other payers as they “jump on this bandwagon.” Regardless of contract provisions, you will find CMA to be the most user friendly contract modeling system in the industry.

CMA accurately identifies all the money deserved under each contract, generating an easily understandable voucher for each patient claim that explains the exact terms of the contract (e.g. stop loss, fee schedule, etc.) that were used to calculate the expected payment. CMA allows users to perform contract simulations to negotiate move favorable terms before signing or renewing existing agreements with insurers. CMA will help increase contract underpayment recoveries by managing contracts more efficiently and effectively.