Download PDF 

Over eight years ago, one of the nation’s leading academic medical health systems, sought to find an automated solution to manage their payer contracts. As a large system, it was critical to ensure they were receiving accurate reimbursement from the payors.

Duke University Health System (DUHS) implemented MedAssets Contract Manager tool and continues to expand this partnership to meet the emerging needs of the growing healthcare system.

Using MedAssets Contract Manager, DUHS electronically processed over 1.5 million claims in FY 2009. With Contract Manager, DUHS can generate reports to track payor payment trends and identify systemic payor issues. As a result, DUHS is positioned to collect and recover 100% of its net revenue due from payors. Over the past six years, DUHS has recovered $58 million in underpayments, $11.3 million alone in FY 2010, realizing year-over-year savings due to the ability to fully automate the complex payment terms with Contract Manager. Additionally, DUHS, has been able to identify and close loopholes in payor contracts in its payor negotiations.

“We use Contract Manager to accurately track payments and contracted variances,” said Cecelia Moore, chief operating officer of DUHS’s patient revenue management organization. “It’s like a barometer for reporting and we use it to improve customer services, identify registration and billing issues and verify accurate posting of contractual adjustments. The MedAssets solution has had significant impact on DUHS’s economic health.”

“We are extremely pleased with the flexibility of MedAssets contract loading and the ability to track payment variances either by contractual adjustment or payment variances. With the use of MedAssets Contract Manager along with our highly motivated staff, Duke Health continues to have a substantial return on its investment. In addition, we have integrated the process in other ways within the organization which has produced verifiable benefits. Our 2009 collections were in excess of 9 million. Even though we have seen a modest reduction in collections in the last couple of years based on reviews, this can be attributed to the payors paying correct the first time and improvements to internal processes, therefore our association with MedAssets continues to improve our bottom line,” said Charles Cockman, hospital quality assurance manager.