Current Situation
There are independent, uncoordinated payment reimbursement engines executing multiple methodologies in siloed systems.
Goals and Objectives
Create auditable, traceable financial transactions that are reconcilable between fee-for-service (FFS) and fee-for-value (FFV) transactions.
Technology Deployed
Prospective reimbursement engines; Retrospective reimbursement engines; Reconciliation workflow; Financial subledgers; Groupers; Contract management software; Rating software
Use Case Summary
Flexible, modular payment engines can administer creative FFS and FFV payment methodologies from contract through claim and payment.