Today's contract negotiations have become highly competitive exercises in risk management. With millions of dollars at risk, there's no room for guesswork or intuitive projections. You require reliable numbers. You must approach the negotiating table prepared, with the confidence that comes from knowing the dollars at risk in each version of a contract. You need the authority you get from Visium™ technology.

Contract Modeler provides instant access to any contract. You can modify/add/delete "contract terms" in minutes and create new models "on the fly". Our helpful "Copy" capability means you no longer have to re-load hundreds of codes and rates for a new contract. Simply copy the contract and change the effective dates. Once your model is ready, run actual claims data through it to calculate anticipated reimbursement.

PRICER
The Visium™ Pricer is a proprietary, powerful and efficient application which computes expected payment and discounts based on the respective provider contracts. The Visium™ pricer accommodates complex business rules:

Per Diem Case Rates Percentage Discounts “Not to Exceed” Logic 14 Types of Stop Loss Revenue Codes DRG CPT ICD-9 Per Visit Per Unit ASC

APC Partial Day High Cost Items (including dollar triggers) Non-Covered Items Items Included in Other Services Age Based Reimbursement Boarder Baby Step Down Days Combination Coding Pay Always / Pay in Addition To

Enterprise Contract Management System (ECMS)
ECMS is an expert system for the rapid deployment (loading) and management of contracts. Logically formatted input screens allow for step-by-step loading of and revisions to the business rules. Users can make multiple and simultaneous changes to all of the "business rules" of any contract (Modify / Add / Delete). Filtering and “mass updating” make the process even easier. (Example: Increase all DRG casae rate reimbursement by 2.74%...done in less than 15 seconds!)

Reliability The process of modeling begins with the establishment of the "baseline", representing reimbursement under the current contract. Reliability is established by virtue of verification of the baseline to your actual claims experience. Reporting Reporting is presented in Aggregate and Drilldown Reports. Raw data can be exported to any number of applications so you can create the reports and analysis you need. Of course, we are always nearby to create custom reports to generate directly out of the Contract Modeling utility. Reimbursement Dynamics Modifying multiple business rules concurrently can often yield unexpected results because the environment is complex, interdependent and fluid. The Contract Modeler easily computes multiple and simultaneous modifications to a contract and reports aggregate and drill-down reimbursement expectations dynamically, sometimes bringing to light unanticipated and unexpected results (“Reimbursement Dynamics”).

Predictive Analysis The managed care contracting environment is no place for guesswork. The Contract Modeler removes all ambiguity from the modeling process and replaces it with reliable, quantifiable results that you can count on. You know the implication of the smallest change to the business rules, right down to the service level. Contract Management The Visium™ Modeler offers the added benefit of Contract Management, allowing you to centralize and manage your contracts more effectively. Organize all your contracts in a single application for quick reference and easier maintenance. You can: Centralize all your contracts and related documents View any contract and the plain language Contract Summary Access the underlying "contract terms" for a clear, concise audit trail Model "business rules" that you intend to propose for the next contract Continuously model counter-proposals during the negotiation process