Provider Contract Management demo
Ask any question of a provider agreement or fee schedule; get the rate or clause in force on the date of service. 1:15
What the demo shows
A contract search solution for health plans that returns the rate in force on the service date.
Ask for a provider, code and date of service and get a rate card: the contracted rate, its arithmetic and the clause that sets it, with every amendment stacked beneath. Each night every paid claim is checked against its card, so underpayments and overpayments are found before the provider calls.
Transcript
- Provider Contract Management gives health plan claims teams the contracted rate on any service date.
- Miss one amendment in rate setup and claims pay the wrong rate for months.
- Renata asks for Brightwater Orthopedic, a knee replacement, on August 14th.
- The rate card, 1726, set by Amendment 3, page 4.
- Amendments stack like a ledger, slide back to June, and the old rate returns.
- Then the card checks the payment, $212 under contract.
- The cause, a stale setup row, 47 claims like it since July, all paid short.
- Renata signs the cited response.
- The setup fix goes to rate configuration.
- The right rate in seconds, cited to the contract page before the provider calls.
- Built on Botminds: agents, data, screens, and governance on one platform.
Transcribed from the film’s narration. Captions are on the player.