Problem: This hospital needed a strategy for negotiating their PacifiCare contract, a contract that was performing below expectations.
Solution: Using a PDS contract comparison report, the hospital was able to identify that their PacifiCare contact was indeed performing worse than their other contracts:
Next, the hospital looked at their payer specific report for PacifiCare to learn that these cases would have brought in $2 million in additional revenue if they has been reimbursed at the same level as their Blue Cross patients:
Next this hospital drilled down into their data to discover that a quarter of their PacifiCare opportunity was in the orthopedic service line:
Results: The hospital was able to use this valuable information to confidently negotiate for better rates in their orthopedic service line.