Sophical Solutions, Llc

About Sophical Solutions has the premier pricing product available anywhere. We provide hospitals with defensible, competitive and fewer high prices while generating the maximum amount of additional net revenues. In addition, we deliver competitive DRG, surgical and ED case charges. We accomplish this with minimal change or no change in gross revenues. We can also assist clients develop more competitive out-of-pocket costs for patients with no negative impact on insurance payments to the hospital. Unique Features The combination of our solution’s many features makes it unique. Some of these features include: client selects competitor hospitals, prices are leveled/stepped appropriately, ability to differentiate between time charges and hardcoded surgery prices, modeling all managed care contract terms, modeling all contracts, utilizing claims level data, addressing “lesser of” losses, incorporating caps on charge increases when setting prices, identifying and obtaining contracts not provided by clients, developing and testing the mapping of plan codes to contracts, running multiple scenarios, incorporating the clients changes into proposed prices, determining the impact of price changes on inpatient and outpatient Medicare outlier payments, determining the impact of price changes on cost-to-charge ratios, and monitoring the actual results against projections. Dashboard In addition to providing a presentation and Excel files, we provide a web-based dashboard with the project results. The dashboard is interactive so you can drill down and slice the results on numerous dimensions. Collaborative Working Relationship We do not force our solution on clients. We listen to our clients and incorporate each client’s unique needs and challenges into a customized solution. Clients We have provided pricing solutions to hospitals and healthcare systems across the country. Our clients range from 25 critical access hospitals to a 3,360 bed healthcare system.