eprovion is a modern provider management system designed for payers, that automates contract workflows for various provider types. The system integrates tightly with claims systems to enable accurate contract loading and makes available claims-based provider profiles.

Later versions of eprovion will include such features as claims issue tracking, business intelligence, and disease management. The system is web-based and enterprise-class i.e. it is scalable, secure, robust, and offers high availability, and high performance.

Provider Contracting

eprovion supports the entire lifecycle of contract management - from preparing for a negotiation using provider profiles, to planning a negotiation calendar, to monitoring the contract during its lifetime and finally the renewal or termination of the contract. All of this is supported in one easy-to-use environment with powerful MS-Office integration. Contract templates can be created for reuse, and contracts can be annotated, versioned and batchprocessed.

Provider Reimbursement

In eprovion there is support for various reimbursement methodologies for physicians, medical groups, hospitals and ancillaries. The methods for physicians include capitation and fee-for service models. For hospital contracting discounts, per-diems, DRG and APC based models are supported. Contracting for networks, medical groups and ancillaries is also supported.

Claims Integration

eprovion brings a new level of efficiency to claims processing by enabling accurate contract loading. There are tools for mapping contract clauses to claim system parameters, and for automating the loading of contracts into claims systems. eprovion's claims integration also enables the creation of provider profiles from claims data.

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