In the September 2011 issue of Becker’s Hospital CFO magazine, Bob Herman wrote “When it comes to health insurance contract negotiations, the battle between hospitals and insurers can be of heavyweight-caliber.”
He went on to observe that “Hospitals must negotiate with their payers periodically, and it might not always be an easy task”.
Unbeknown to Mr. Herman was a CostFlex Systems software invention (1992) that allows the provider to automate the legal terms of any health insurance contract and make the negotiations rather routine and profitable, at least for the provider.
Once a hospital user is trained on the software, it takes only a hour or so to fully automate a new, inch thick, legal contract. And the profitability of each contract term can be immediately tested.
The automated contract terms can be immediately tested because at least one year of patient history is loaded into the database during the turnkey installation of the CostFlex Activity Based Costing system. And every discharge thereafter adds to the repository of detailed patient data and costs.
Once established, the automated contract terms and the availability of electronic patient data allows the provider to quickly test the efficacy of new terms proposed by the payer’s negotiator.