Caribou Systems Incorporated - CProPlus - Provider Reimbursement and Claims Pricing

CProPlus - Includes Provider Reimbursement and Claims Pricing

CProPlus contains all of the elements of CPro, plus Provider Reimbursement definition and claim pricing calculations. Its Provider Pricing Interface accepts membership and services information from a claims system, retrieves the appropriate data stored for the provider, calculates the payment amount, and passes it back to the claims system.

CProPlus calculates even the most complex reimbursement contract arrangements. Its pricing structure flexibility enables you to write contracts the way you need to in order to compete in today’s marketplace.

CProPlus System Features

Pricing methods include fee schedules, DRG/APG's, per diems, discounts/exceptions, RVU and RBRVS, lesser of and global pricing.
Supports a comprehensive pricing structure that allows multiple reimbursement methods per provider and network.
Implementation includes a systematic conversion of existing pricing structure information into the CPro data repository.