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How to Address Next-Gen Payment, Claims Management Systems
HC Pro

Taking contracts and associated claims from negotiation to adjudication has never been more complex.

Payors struggle to manage contracts that vary from facility to facility, from procedure to procedure, with significant deviation within each contract. These highly complex agreements are usually negotiated by hospital administrators and lawyers, and are frequently expressed in phrases that must then be interpreted by the operations staff and put into precise terms that can be executed by claims systems or processed manually by claims staff.