|
|
|
|
|
| Park Nicollet Health Services utilizes Alliance Decision Support® to recover over $12 million in underpayments |
|
 Download PDF
|
| Problem |
|
Park Nicollet Health Services, an integrated healthcare system with headquarters in suburban Minneapolis, Minnesota, has been a MedAssets client since 2001, utilizing Alliance Decision Support to identify and collect underpayments from payors, identify discrepancies between contract terms and actual payments and identify and streamline future organization processes.
Fred Price, Manager of Reimbursement for Park Nicollet Health Services said, “The Twin Cities is a very competitive provider environment. Percent of charge contracts are very limited. Therefore, it was extremely important for Park Nicollet Health Services to develop a tool that ensured services were being paid according to contract terms.”
Park Nicollet Health Services has a very large owned clinic practice (more than 25 neighborhood clinics throughout the greater Minneapolis/St. Paul area) as well as a large hospital and two ambulatory surgery centers. They needed to monitor hospital outpatient and clinic professional services as well as inpatient revenue. |
| |
| Solution |
| Over the last three years, the Park Nicollet Health Services Payor Relations staff has modeled over 95% of their payor contracts including inpatient and outpatient terms. They actively compared actual versus expected reimbursement, and used data from Alliance Decision Support to demonstrate underpayments to key payors. The internal audit team works the data/reports to follow up with the payors. |
| |
| Results |
| The Park Nicollet Health Services team has integrated the use of Alliance with their overall managed care operations process, and routinely prepares underpayment appeals that are submitted directly to payors. As a result of these appeals, William Telleen, VP Payor Relations, indicated that documented recoveries have exceeded $12 million over the last four years. | |
|
|
Improve your
Operating Margins
MedAssets improves
and sustains
operating margins
by 1.5% to 5%.
 |
|
|
|
|
|
|
|
|