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Contract Management

NHXS Payment Solutions

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  • Analyzes payer agreement and identifies underpayment
  • Generates dispute forms and paperwork, and tracks the dispute
  • Integrates with athenaCollector®
  • Delivers reimbursement intelligence, including contract modeling

Put an end to underpayments

Navigating complex reimbursement methodologies can be tough. When it's time to recover potential lost revenue from underpaid claims, your administrative costs can escalate quickly. NHXS can help. As the leading provider of contract compliance and point-of-service adjudication workflow automation, their solutions make the process simpler, placing robust reimbursement intelligence in your hands.

What It Does

NHXS gives providers the ability to identify underpaid medical claims, automates the dispute, and tracks the recovery. It provides a comprehensive decision support system for analyzing payer agreements, and a real-time estimation tool to calculate patient responsibility.

Product Details

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Designed to measure payment accuracy and reduce the cost of dispute resolution. Makes it easy to generate first-level appeal documentation that includes payer-specific dispute forms and letters, including copies of the claim and EOB.

Features and Benefits

  • Variance reporting: Identifies costly underpayments and overpayments
  • Appeal documentation: Automates the completion of payer dispute forms
  • Recovery tracking: Provides a built-in return on investment (ROI)
  • Super-explanations of benefits: Creates an enhanced explanation of each payment, allowing underpayments to be worked efficiently
  • Maintenance of contract terms: Removes the burden of understanding and maintaining payer-specific pricing and clinical edit rules
  • Powerful, easy-to-use dashboard reports: Provides reliable revenue-cycle benchmarking data for comparison against peers
Contract modeling tool that allows users to create "what if" scenarios to determine the impact of changes to a fee-for-service payer contract. Uses the group's historical data to determine whether a change will result in an increase or decrease in reimbursement.

Features and Benefits

  • Instant contract modeling: Eliminates the manual process of analyzing agreements by measuring whether a proposal will increase or decrease revenue
  • Custom procedure code groupings: Identifies the net impact to procedure code groupings and specialties
  • Quick comparisons: Builds and compares "what if" scenarios on the fly with unlimited scenarios
  • Historical data: Uses custom date ranges for any payer to isolate data needed for a historical analysis
  • Maintains payer rules: Measures the impact of contractual adjustments including fee schedule, pricing and clinical edit rules
  • Forecasts revenue: Provides the bottom-line impact of contract changes

About NHXS

NHXS is a leading provider of contract compliance workflow automation. Built around a robust claims adjudication and payer business rules engine, NHXS has made it practical to check every line on every claim for payment accuracy. From this foundation, NHXS has created solutions and business intelligence used to simplify and improve the revenue cycle. For more information, visit the NHXS website.

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