Provider Contracts

Provider Contracts are used to enter into the system what services each provider can bill for, the rates to be paid for those services, and the funds available to pay for those services. If authorizations are entered by client, the authorized amount is tracked back to the contract to compare how much is available by fund and how much has been allocated by authorization. As claims are processed, the amount paid is also tracked by fund on the contract record so the user has a quick view of the use of the contract. After the contracts have been entered, a Fee Schedule can be printed and sent to the provider. The Fee Schedule lists the services and rates the provider can bill to the county.

If a rate change occurs during the year and is retroactive, an application can be run that will calculate the difference and process it so a payment or reduction will be made in the next check run. The processed claims will also be adjusted so reporting will also be accurate.