Provider Contracts Module

• Multiple Contracts per Provider

MC/2000 allows for multiple contracts per provider and includes an effective date feature. The flexible contract data base allows you to specify alternate payment methods based on type of service, type of insurance or specific insurance carrier.
 
 
• Multiple Reimbursement Types per Provider

MC/2000 accomodates fee for service, capitation, percent of billed charge, conversion rate, and facility reimbursement types.
 
 
• Multiple Providers per A/P Vendor Number

MC/2000 gives you versatility when assigning A/P vendor numbers. Payment can be made to a provider group under one vendor number, while retaining the specific performing provider in the claims history detail.
 
 
• Track Pool Expenditures By Providers

MC/2000 accomodates risk pool tracking by provider.
 
 
• Provider Responsibility Flags

MC/2000 allows you to specify when copays and coordination of benefits are the provider's responsibility. This feature enables the system to deduct copay amounts during calculation of net payment.
 
 
• Sub-Capitation Processing

MC/2000 accomodates sub-capitated arrangements while maintaining compliant encounter data.
 
 
• Multiple Unit Value Tables

MC/2000 has the ability to reimburse under multiple unit value tables. Tables can be loaded from outside sources or defined by you. Provider contracts then allow you to specify which of your existing tables to use when calculating payment for a contracted provider.
 

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