SMART Reimbursement and Contract Modeling Tool
The software application includes a web interface which allows users to define the expected (health insurance) reimbursement rate for an unlimited number of commercial third party payers (e.g. Blue Cross Blue Shield, EHP, CareFirst, Helix). The application then allows the user to run reports to identify where received payments do not meet the defined contract expectations. The detailed files produced can be sent to the third party payer to request additional payments and the system allows the user to monitor activity on the transactions in the files to determine if additional payments are received and if the additional payments meet the expected payment rate. This software application is run on IDX.
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