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Hi, my name is Marissa Crow, and I’m the Senior Director of Sales here at Ntracts. I’ve been in the healthcare Contract Lifecycle Management space for a little over 10 years, where my day to day role is speaking with hospitals and health care organizations across the country on how we can help them manage their contracts and contract compliance.

Today, I’ll be talking about the top hidden fees of Contract Lifecycle Management implementations gone wrong. And on this topic is specifically discussing organizations who have either migrated from no contract management system, or a competing Contract Management System, or even a good old SharePoint spreadsheet type system, really just the specific costs that can be tied to implementing different solutions, and how Ntracts can help. So we’ll start with the different types of implementations.

Typically, organizations are using one of the few systems a homegrown system, so a shared drive, they form a spreadsheet, some way that’s keeping track of their contracts, critical information around expiration dates, auto renewals, and ultimately just who they’re working with. We’ll also see organizations move to Ntracts from a what we would consider a competing system. So your other Contract Lifecycle Management Systems, and a lot of systems that are specifically what we would, we would categorize as industry diagnostic, meaning they’re not, they’re not healthcare specific. They’re, they’re just in the contract management space. So they work with multiple industries.

In my discussions with hospitals and health systems, we’ve walked through the solution and how we can really help. But a huge component of that is really the front end piece of implementing a contract management system. There are a lot of tools out there that can do a lot of important things. But if you don’t get the implementation, right, if you don’t get your information into the tool appropriately, if you don’t have a team to support you that understand your space, understand your contracts, understand your processes, and ultimately understands the regulatory components that are tied with your contracts. So whether that’s the OIG Joint Commission, d&b, you name it. So in today’s discussion, I’ll be talking about some of those hidden fees, every contract management, every contract management tool has a price tag to it, some are high, some are low, you get what you pay for in a lot of those

instances. But there are also a lot of hidden costs that can be associated with implementing a contract management system that may not be disclosed upfront. So some of the key elements and key areas that I’ll be discussing today are types of implementation services, technical resources, support, and potential limitations in those areas.

So some big questions that you may want to consider when you’re evaluating a contract management system to start is, what type of implementation is included? There are a lot of tools out there that will give you a tool, but it’s up to you and your team, your resources, your time your dollars, to actually implement those solutions. It’s really common in my discussions with healthcare organizations, if you’re in the legal department, if you’re in supply chain, no one has additional time to do these types of things. And you want to be doing your day to day you want to be working at your at top of license on your specific role. You don’t want to have to take the time to find contracts, load them in make sure they’re loaded, right train your sis, train your users build the system, it really is better suited to hand that over to someone who’s has more the expertise. And it’s also going to streamline your timelines. So when we talk about the types of implementation services that are included, we would advise to really dig into that right, they may say a solution may say implementation is included. But what does that mean? Does that mean that we’re going to show you how to use the system and it’s up to you are we going to provide real resources to come on either maybe even come on site and scan paper contracts, maybe help you sort through your existing electronic contract. So maybe we have all of our documents in a shared drive, they’re not organized appropriately, we really need to make sure that we’re getting all those organized prior to them going into a system, or the tool is really not going to matter. So just some other some big questions to ask the build out of the tool, it’s nice to be able to be able to build some things as an administrator of the system, etc. But is the is your partner going to help you build out your workflows, your repository, are there is their ability to customize it. So a big part of the implementation obviously, is designing the system around your contracts in your process. Oftentimes, a lot of tools are really configurable, but you still have to do it. You have to design it, you have to build it out. You have to know what you want. And oftentimes in those scenarios, you’re ending up having to resource that out to a third party or consultant which obviously has big dollars tied to it. So a big value of working with Ntracts being that a we were our 100% 100% dedicated to health care. But we also are supporting you fully through that implementation process and incorporating Best Practices along the way. So we’ve been doing this for a long time and Ntracts was originally founded in 1987, by Hall Render. So we have that just Healthcare Foundation to our system, even from the beginning. But we’re bringing that to the table during the implementation process. So as we’re building out the tool with you, so first off, we’re building it with you, you’re not having to do it. But as we’re building it out with you, we’re bringing to the table best practices, we are bringing to the table, we have worked with an implemented over 2500 healthcare organizations across the country, to help them build out their system. So we bring to the table also, here’s what other organizations are, are doing in their system, here’s what’s keeping them up at night, here’s the regulatory impact on some of these components. And here’s our recommendations, you also of course, get to decide how you want your tool built. But it really makes a huge difference and building out a system if you want to make sure that it’s set up the right way. So some big components that we’re providing, and some big questions that we would recommend asking as part of your evaluation process. And in addition to that, Are there fees for that a lot of times organizations will charge a separate implementation fee to implement a Contract Lifecycle Management System. And practice is not it’s a big value add with us, we do not charge for implementation or training for that matter. training

alone, as I’m sure a lot of administrators who may be watching this video can attest to, it takes a lot of time, it takes a lot of time to sit, sit down and training user and continue to provide educational materials, or build out the educational materials to give to give your end user Ntracts takes that heavy lifting off as well, we will we will provide the training for your team, we will train based on the role. So an administrator of the tool that needs to do so many things in the system does not need that high level of training, they someone that just needs to come into the tool and view contracts or request something that’s a much simpler training, we provide educational materials, as well. So to be able to reference our reference guides, again, all of those things take time, they take resources, they can take money on your organization, we take all of that off. So as you’re evaluating solutions, not only it what implementation services are included, are there limits to that. So sometimes organizations will say we’ll help you with implementing, but you only get X number of hours of support from us. If you go over that, then there’s an additional fee. I talked with healthcare organizations all the time, where they’re blowing through those hours before the implementation is even halfway done. So those are additional costs you’re already in, you’re already in it. So you kind of have to keep going. And it’s additional costs that that weren’t planned for budgeted for that you don’t have to do. So again, some some big areas to look out just around implementations as a whole.

Another big component is who is doing your implementations are the implementation services outsourced, meaning they’re outsourced to a third party, maybe it’s someone that doesn’t understand this, a doesn’t understand the healthcare space, but maybe they’re just really that IT support, they don’t have the consultative type approach to building out your contract management system. Again, good data in good process and good data good process out, we want to make sure that we get it right on the front end, and then put it into the system and let the system do all the amazing things that it does. But if you put the wrong process and you put the wrong data in, the tool really doesn’t matter. Right. So it really makes a big impact on the initial implementation process.

Once we’ve understood who’s doing our implementation, what level of expertise do they bring to the table? Are they again, are they maybe just bringing the IT support which is needed, obviously in in technology implementation? Or do they have that expertise in your space? So specifically for us, our organization is designed for healthcare 100% dedicated to health care, we also have a 100% implementation success rate. So really proud of that that’s hard for a lot of organizations to say, but specifically the individuals that are implementing your system, do they understand contract management?

Do they understand healthcare contracts? Do they understand the difference between a physician contract and a vendor agreement and a payer contract in a lease? Do they understand the impact of the regulatory requirements that are so different for each of those things? And all of the different processes that have to be followed the standard policies and procedures that have to be incorporated, making sure that someone understands that expertise is going to help make the implementation not only run smoother, but it’s going to design design wise, it’s going to match your process, your end users are going to be happy because the tool feels like they designed it because they did right they were involved in the implementation process and our team really helped guide that guide that initiative

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specifically around Around the expertise as as I mentioned, the implementation team who is provided with that the expertise that’s brought on for that initiative. Another component to really pay attention to during your implementation process is what IT resources are going to be needed? Is the solution you’re considering an on prem solution? Or is it SAS based?

If teams are constantly working on big initiatives, large projects, it takes a lot of time, as I’m sure you all can relate to that to implement any type of technology making sure we have the appropriate IT resources involved, or just our appropriate internal resources involved as a whole. So a lot of times those projects can are going to have to be scheduled out, it is busy, they have a lot of projects, we need to make sure the right risk assessments are done, which obviously most organizations should be happy to do. But as far as the build out of the tool, what IT resources, what technical resources do you need. Big value with Ntracts is we are very what I like to say it like obviously, it is more than welcome to be involved in our implementation processes. But we really take the heavy lifting off of your organization, not only from your legal compliance, purchasing teams, whoever’s managing the contract tool, but your IT teams as well, the minimal IT requirements that we need our eyeties help with in implementing single sign on, which is a pretty straightforward implementation. But we usually get a lot of positive feedback that we really don’t need much IT support, it has enough things going on. Let us take that on. We provide the implementation support from an IT perspective during the implementation process, and ongoing. So maintenance, all that sent by us. And regarding implementation, I’ve talked about a that included be how much is included and see who who’s providing that service to you.

Something else to think about during the implementation process around how much is included, I mentioned, you know, are there limits on ours are there set costs for that, etc. But as you think about ongoing support, what does support look like post implementation, right, we provided you a solution, we got your tool up and running. And then once it’s live, a lot of organizations, unfortunately, they’ll say kind of call us if you need us, there may be a help desk, you can reach out to us base, maybe not. They may provide account management, maybe not. And so the ability to understand who’s going to support your organization moving forward with the Ntracts solution, not only as I mentioned, that we do we help heavily in the implementation process. But the support definitely doesn’t stop there. We provide a client support advisor immediately post go live, that is someone who has been involved in a in the implementation process, they so they understand your organization, they understand your processes, they understand your contracts, that person stays on immediately post implementation to help with the official transition on to Ntracts, we have found that that is is the most effective way to help with user buy in to be able to make sure that the tool is is routing appropriately, we do a lot of proof of concept during implementation. But once real contracts or routing through new users are in the system, we we things may be tweaked or changed and more education needs to be provided that client support advisors role is to help with all of that for a temporary amount of time post go live, we have found that it is extremely effective with user buy in. And it is made sure that users like the system etc. As it goes live. Post that client support advisor we the support doesn’t stop with Ntracts, we have a help desk and account management team that are at your fingertips for anything that you need as well. I cannot say enough great things about Ntracts implementation support, but just support overall, we have a 98% client retention rates, we’re really proud of that. And a huge component of that as our support, if you talk to our clients. That is the biggest thing that they will tell you is that the support for Ntracts is phenomenal. We had a client tell us that it feels like we that they are our only client. That’s how well

they’re supported within Ntracts. So I can’t say enough good things. But it’s also something to really look at when you’re evaluating contract management solutions. Is what’s the implementation support look like? We’ve we’ve covered that, but ongoing? What type of support do I get to get support? Is their account management Help Desk? Where are they located? What are the hours? How often can I reach out to them? Are there limits on reaching out to support? So a lot of organizations or a lot of contract management systems? If they’re capping the implementation hours, they’re probably capping the support hours too. So something that you should consider as you think about how much support am I going to need? Am I gonna is it going to be a hidden cost that I’m not accounting for making sure that we’re really understanding that before we make our decisions on a contract management solution? So ongoing support help desk it really again, makes all the difference in the world. If a user is stuck in the system, they can’t figure something out. It’s going to Do not help with user by and right, if a user is frustrated, they can’t figure something out, they need someone to be able to help them, we provide training to the system administrator at your organization. So they should a system administrator or depending on how large your organization is multiple System Administrators should be available as an internal resource. Again, we provide resource guides, again, our team builds those, you don’t have to build them. A lot of times those resource guides will also be linked into an intranet. So maybe it’s even part of your onboarding process. So being able to even have that part be associated, but making sure that that user feels supported. It makes all the difference in the world with that user liking the system and making sure that you have that user buy in, which obviously trickles down the stream of users are using the system. It’s making us more efficient. It’s providing us that ROI, how many days are we saving, just not having to answer a million phone calls of where am I contracts? How do I do this all that supported by Ntracts, we build it out with you to really make sure that you’re capturing all of that important information. Again, really impactful information and really some just big topics as you’re considering Contract Lifecycle Management Solutions. Not every solution is the same. Not every tool has the same exact functionality. And every organization is definitely not providing the same level of support and expertise. So really just some key elements to really look at your contract management initiatives. And make sure that we’re really looking at the whole picture from a cost perspective, from a resource perspective, from a timing perspective, and just making sure we have all of our questions answered as we look through the system. If you have any additional questions about Ntracts and how our implementation process works, what our support team looks like, or even just overall information about our expertise in this space, we’d love to talk with you. Thanks

Contract Lifecycle Management (CLM) systems are essential for healthcare organizations looking to manage their contracts effectively. Getting through the CLM implementation process without your documents and data loaded or migrated appropriately into the platform can commonly result in a multitude of unforeseen, negative outcomes: extended implementation periods (sometimes taking up to a year or more to get implemented), data loaded incorrectly, and unexpected costs of implementation.

In this article, we’ll delve into the common pitfalls of CLM implementations gone wrong and how these issues can impact healthcare organizations.

Understanding the Initial Costs

When healthcare organizations transition from a homegrown system, a competing solution for tracking contracts, or even basic spreadsheets and network drives, they often encounter significant challenges. The primary issue lies in the implementation phase. While every CLM comes with an initial price tag, if the implementation goes wrong, the health system must pick up the additional burden.

The hidden costs that can weigh down a healthcare organization trying to get its new CLM off the ground are not only financial. These costs can also come in the form of additional internal resource costs and a financial burden due to extended timelines.

The Anatomy of a CLM Implementation

A well-executed implementation starts with a clear understanding of what is included in the service—you should know if you’re getting a basic set up that requires your own organization’s resources and additional fees to complete the implementation or a comprehensive, hands-on approach that covers everything from data migration to workflow customization. Commonly, CLM platforms will provide a basic, limited setup, which can be especially dangerous or costly for healthcare organizations.

The implementation process is a significant part of the overall success and adoption of a contract lifecycle management solution. Without your information getting loaded into the tool appropriately and without a support team that understands the healthcare industry, healthcare contracts, and regulatory requirements associated with contracts as governed by the Office of Inspector General (OIG) Joint Commission, DNV, etc., your users and your organization as a whole will not only fail to reap the benefits you were expecting through enhanced efficiency, transparency, process standardization and governance controls your organization may also be at risk of non-compliance.

Understanding Different Types of Implementations

The first hidden fee to consider is the type of implementation service included. Some CLM vendors provide a tool but leave the burden of implementation on the healthcare organization. This means the organization must allocate its own resources, time, and money to get the system up and running. This often involves scanning paper contracts, organizing and uploading electronic documents, setting up your own fields and workflows and training users, which can be overwhelming for staff who are not experts in implementing technology platforms and already have their hands full with their primary responsibilities.

A robust CLM will provide implementation resources and consultants as a part of their implementation process and without additional fees and will work as a partner providing trusted recommendations and guidance rooted in best practices, limiting the amount of decisions the organization needs to make and therefore further increasing the efficiency of the implementation.

At Ntracts, we have found the most effective way to increase user buy-in is to make sure that the solution is implemented appropriately and those on the organization’s core implementation team has an opportunity to review the set up. We incorporate and complete a proof of concept period during implementation to ensure the design decisions made during implementation meet the needs of the organization. This includes review of the architecture, data and documents uploaded and workflow routing. Once this period is completed and real contracts are routing through and new users are in the system, the organization transitions into brief stabilization period. During this time, we may see minor adjustments are needed to ensure process conformance, or more education may need to be provided. It’s during this time our client support advisors step in to help provide a dedicated resource for a temporary amount of time to support the transition immediately post go live. We have found this is extremely effective for user buy in and adoption across the organization.

Communication, Training and User Buy-In

Training is often a hidden cost in CLM implementations. Proper training takes time and resources, and inadequate training can lead to user frustration and low adoption rates. It’s important to ensure that the vendor you select provides a comprehensive communication plan, training and educational materials to support the organization’s needs.

After all, what good is a CLM if no one knows how to use it? Resource guides, training materials and training sessions should be provided by the CML partner.

Understanding Who’s Performing your Implementation

It’s important to understand who will be performing your implementation. Implementations are often problematic if your implementation consultant doesn’t understand the complexities of healthcare contracting or IT support teams not experienced in implementing CLM solutions are responsible for completing implementation. Outsourced implementation teams typically don’t have the level of understanding of your industry and your processes that need to be properly implemented.

They may not have ever dealt with healthcare contracts in a CLM solution before, much less will they understand the different information that should be captured for various types of agreements such as physician contracts, a vendor/IT agreement, payer contracts, or real estate lease agreements. Implementation teams who don’t understand the differences between these contract types are not going to understand the impact of regulatory requirements that are so different between each and how that should affect how your CLM is implemented.

In this case, many organizations find themselves needing to hire third-party healthcare contracting consultants to build out better workflows, repositories, and customizations for them. This can be costly and adds to the overall expense of the CLM system.

Outsourced Implementations

Often, CLM providers will outsource CLM implementations to third parties. This causes issues for a multitude of reasons. First, outsourced providers may rely on standardized approaches, which might not fully align with the specific needs and nuances of healthcare organizations. If the implementation consultant lacks expertise and experience, the quality of the implementation might lead to a suboptimal CLM system.

Furthermore, CLMs who outsource their implementations have less control over the implementation process that can lead to significant delays. There is also concern around sharing sensitive contract data with third parties, which can introduce security and compliance risks, especially if the provider doesn’t have robust data protection measures in place.

CLM solutions who don’t include a comprehensive implementation process might reduce upfront costs, but they often lead higher long-term expenses due to ongoing and unexpected implementation fees, fees for change requests and continued implementation support. Implementations conducted by third parties not employed by your CLM solution inevitably leads to longer implementation timeframes and unexpected costs.

And once the implementation is completed, the organization is often no longer responsible for servicing the organization without a support contract for edits or adjustments, not only does this lead to increased costs in the long run, but there is also often lack of accountability on incorrect implementations – the third party consultant has moved onto the next project and isn’t responsible for servicing and supporting the client’s CLM use.

Questions to Ask About the Implementation Process:

  • Do you provide account management post-implementation?
  • Is your implementation process outsourced to a third-party?
  • Does implementation include a call to contracts, supporting organizations in gathering and scanning paper contracts, if needed? Or help organizing digital contacts hosted on a shared drive for upload, for example?
  • If transitioning from another CLM, does implementation include support mapping data and associating contracts appropriately?
  • Is the solution configurable? If so, does your team take on the burden of building that out or does the CLM solution handle designing and building out workflows and the repository?

Questions to Ask About Post-Implementation:

  • What type of support is offered immediately post implementation?
  • Is support included?
  • Where is the support team located? What are the hours?
  • Are there limits on reaching out to support?
  • Is there a cap on support hours?
  • Am I assigned an Account Manager?
  • What about training?

Post-Implementation Considerations – Ongoing Support and Maintenance

Post-implementation support is another critical factor in the success and adoption of a CLM within an organization. Some vendors provide limited support hours, leading to additional fees when those hours are exceeded. It’s vital to understand the level of support offered, including whether or not there is a help desk to contact, an assigned account manager, and whether there are caps on support and training hours. It is important to make sure you understand what support looks like after the implementation period and moving forward.

Internal IT Resources

Technical resources play a crucial role, especially in ensuring that the system is integrated smoothly with existing infrastructure while minimizing the burden on internal IT teams. The involvement of IT installation resources is another area where costs can add up and implementation time can be significantly extended – costing the organization both time and money.

If the CLM system is not SaaS-based, or isn’t fully supported by your selected partner, it may require significant IT support for implementation, maintenance and ongoing help desk support. If IT resources are required to set up the CLM, make sure to ask for information about resource allocation necessary from your IT team, when they’ll need to be involved and what their responsibilities are. Not just during implementation, but ongoing. With many IT projects happening in an organization at once, departments must often submit projects to get on an IT department’s schedule. if the new CLM requires a large install that needs lots of internal IT support, these timeframes may be extended, or the project start date may be delayed – which can impact an organization goal and overall CLM initiative. Ensuring that you are working with a CLM vendor that requires minimal IT requirements from your team and takes on the heavy lifting can save the organization time and money.

In Conclusion

Hidden fees in CLM implementations can lead to significant financial and resource strain for healthcare organizations. It’s essential to thoroughly evaluate the implementation services, technical resources, support, training, and IT requirements offered by the vendor. By understanding these hidden costs upfront, organizations can make more informed decisions and choose a CLM solution that meets their needs without unexpected expenses.

At Ntracts, we pride ourselves on providing comprehensive implementation and ongoing support services tailored specifically for healthcare organizations. Our dedicated team of in-house implementation consultants are experts in healthcare contracting, CLM implementations and regulatory compliance surrounding contracts. Bringing industry best practices, they ensure that the implementation process is smooth and efficient, with no hidden costs.

If you have any questions about our CLM solutions or need more information about our implementation process, please don’t hesitate to reach out. We’re here to help you manage your contracts effectively and efficiently.

About Missa

Missa Crow
Missa CrowSenior Director of Sales

Missa Crow has 12 years in healthcare contract lifecycle and procurement solutions. She has expertise in healthcare CLM covering all types of contracting, including purchasing, physician, IT, lease and payor agreements. Missa’s role includes working with healthcare organizations across the country to understand their contracting needs, regulatory requirements, and ways to improve their contracting processes. Missa is an active member of AHLA and HCCA. 

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