Reference
Payer Contract Lifecycle Management glossary
Terms used in Payer Contract Lifecycle Management and its documentation.
Applies to Payer Contract Lifecycle Management as it works today. Moraph updates the platform continuously, and this page is reviewed when it changes.
Terms used in Payer Contract Lifecycle Management and its documentation.
| Term | Meaning |
|---|---|
| Contract model | The contract's payment terms set up so expected payments can be calculated. |
| Repricing | Calculating what a claim should have been paid under the contract version in effect on the date of service. |
| Expected payment | The amount the contract model says the payer should pay. |
| Variance | A difference between expected and actual payment above the tolerance. |
| Systemic issue | A group of variances sharing the same cause, raised with the payer once. |
| Lesser-of provision | A term paying the lower of the contracted amount or billed charges. |
| Stop-loss | A term changing the payment method when charges pass an agreed threshold. |
| Carve-out | A service paid separately from the main payment method. |
| Notice date | The last date to tell the payer you intend to renew, renegotiate or end the contract. |
| Write-off | A decision not to pursue a variance further. |
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