Physician and Provider Contracting is complex, but your software solution doesn’t have to be

January 24, 2023 Bahareh Bahary

Support understaffed administrative functions with automated contracting. 

Healthcare contracts are notoriously complex, partially because it is nearly impossible to predict or manage every potential outcome – especially in multi-jurisdictional scenarios, multi-faceted relationships, and multi-stream compensation models. Data support can deliver accurate, reliable and timely information, giving your teams the information they need to make well-informed decisions. Modern contract systems must be integrated and involve your organization's clinical and financial functions.  

The complexity of clinical environments requires a unique approach to contract management that considers the challenges of a healthcare setting, focuses on the specific needs of healthcare contracting and provides clear, intuitive tools to effectively support your administrative team.  

Four contracting challenges an industry expert can help you navigate:  

Sensitive relationship management:  

The intricacy and sensitivity of managing relationships with physicians, clinicians, payers, partners and affiliates can be overwhelming. Your contracts – and the processes necessary to negotiate, execute and track them – are the starting point of your relationships. Clarity, consistency and reliability are essential in ensuring these important relationships start out on the right foot. The ability to track the commitments you make – and the obligations the other parties agree to – must be automated so that your team can focus on the relationship itself without worrying about managing spreadsheets and unwieldy email threads. 

Staff shortages and oversight:  

Staff shortages often lead to time delays and errors in contract management processes – especially within manual processes. When each contract is started from scratch, your staff members must engage in a tangle of manual, self-defined tasks which are inefficient, prone to error and unsustainable. Staff burnout and dissatisfaction are rampant. With a comprehensive contract management system, tedious tasks are easily automated, controlled and standardized. These systems let your team focus on managing the relationships and strategic functions, and capture data, approvals, drafts, negotiation details and audit details so oversight is built into your process.  

Poor compliance and audit traceability:  

Systems and manual processes which are not designed to manage data and contract language in a holistic, structured manner introduce inconsistencies in data capture and legal language, as well as a lack of business term search capabilities within your contract management repository. Manual, inconsistent processes jeopardize compliance with privacy and oversight regulations. Additionally, manual practices introduce gaps in audit traceability, lack of accountability and inability to hold parties responsible for commitments. 

Long contract lifecycle approval processes:   

More complex agreements require an extended approval process involving multiple approvals, drafts throughout the negotiation and an extended contract lifecycle. A lack of visibility across siloed internal teams may lead to duplication of labor-intensive efforts, placing unnecessary administrative burdens on your team. Without a cohesive contract management system, your team is left with contracts and drafts via email and poorly structured file systems. Further, since the contracting phase often constitutes the first formal engagement with your organization and administrative processes, the first impression your organization makes with the contracting process is critical. An inability to manage this critical opportunity effectively and efficiently for engagement, and the delays inherent in a poorly managed process, may result in negotiation failure. 

How advanced Contract Management tools can help you 

Ernst & Young reports most large organizations have a formal contracting technology strategy, but almost all companies lack the data and technology necessary to improve their complex contracting process. As a result, more than half of organizations say these inefficiencies have cost them business, according to EY. But with automation, Aberdeen reports administrative contracting costs may be reduced by almost one-third of the original price.  

Rather than continuing to lose between five to forty percent of contract value due to administrative flaws – as Harvard Business Review finds of most businesses – we must work together to discover a solution to the inefficient contracting process.  

Healthcare providers must find ways to simplify administration and management before and after they are executed because of the significant link contracts have to patient care and the huge potential and regulatory issues that arise when contracts are administered manually.  Additionally, your organization needs a contract management tool that will empower your legal team with the tools and complex language library to support the high-risk contracts of a healthcare setting. The adoption of digital solutions such as contract lifecycle management (CLM) can assist healthcare providers to negotiate better, compliant contracts faster and guarantee that the negotiated terms are successfully carried out in practice.  

Why RLDatix 

RLDatix is taking the lead in introducing integrated CVO plus services and Contract Management. By integrating with finance, business, marketing, sales and other healthcare software from the world's leading suppliers, we help provide enhanced visibility and control over contract data and information regardless of where it lives. We mitigate reputational and regulatory risks while facilitating compliance and governance audits.   

Patented AI-Powered Language Library 

Our software is equipped with patented AI-powered language library complexities to automatically assess language in redlined contracts and third-party payer, identifying and targeting crucial high-risk provisions. Additionally, this feature facilitates automatic language identification requiring legal review, making it effective more quickly and cost-efficiently than competitors. Our software produces an 80 percent reduction in contract processing time, a 10X increase in regulatory filing throughput and saves approximately $600,000 annually for an average-sized hospital.  

Increased Operational Flexibility in the Face of Regulatory Shifts:  

By digitizing and centralizing contracts, it becomes much easier to identify which clauses are impacted by regulation changes. The automated approach allows teams to make mass contract edits and deliver them to stakeholders for approval, keeping the firm responsive regardless of the legal situation.   

Our expertise 

We know healthcare, and we deeply appreciate the nuances and complexities that come with it. We have a crystal-clear understanding of the challenges physicians, providers, and payers face, and we can provide efficient solutions to address their contracting needs. Our software integrates, centralizes and streamlines your contracting processes, meeting your organization wherever it is. We handle the complexities of healthcare contracting daily and know that a successful contracting process can lead to better, safer care. 

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