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An item says "not on contract." What does that mean?

What the not-on-contract flag means on a case item, and what action if any you need to take as the rep.

A not-on-contract flag means the item isn't on the facility's active contract as it's currently loaded in Helia. Here's what to do depending on where you are in the process.

If you're seeing the flag before you submit:

Before submitting, check the following:

  • Does your corporate team know of a contract or amendment that covers this item at this facility? If yes, that's the most important thing — note the contract number and submit a ticket by clicking the chat icon in the bottom right corner before proceeding. Include the item number, facility name, and contract number or amendment reference.

  • If you don't have a contract number or amendment reference, check with your corporate team first. Do not submit the case assuming the facility will approve it.

  • Read the health system's not-on-contract rule displayed when adding the item — it will tell you what pricing policy applies. Follow that rule before submitting.

If you've already submitted and the case is in Pending Review:

Your case isn't stuck — it just needs that item reviewed on the facility side. You don't need to do anything unless the case gets rejected back to you.

If the case gets rejected back to you:

  • Read the rejection comment — it will explain what the reviewer needs.

  • If the item needs to be removed, remove it.

  • If the item price needs to be updated, update it following the health system's not-on-contract rule.

  • If you believe the item is covered under a specific contract or recent amendment, submit a ticket by clicking the chat icon in the bottom right corner with the item number, facility name, and contract number or amendment reference.

Tip: Having a specific contract number speeds up the resolution significantly.

Still need help? Click the chat icon in the bottom right corner to submit a ticket.

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