Provider Contract Management

Efficient. Proactive. Compliant.

Streamlining Healthcare Contracts

Health plans spend $3 billion annually to maintain provider data quality and contracts. Provider contracts today are managed manually, impacting cost and quality of provider data. Lack of quality and rigor in demographic information and pricing configuration results in compliance and administrative risks for health plans. Health plans grapple with provider contract loading complexities due to frequent amendments for new business ventures and unique contracts for each business line and insurance type. These complexities lead to extensive manual work, increasing the risk of errors and slowing down contract processing, which impacts both payments and compliance.
Our Intelligent Provider Contracts solution leverages AI to extract, validate, enhance and load provider demographic and pricing information from contracts, improving provider data accuracy and operations for plans.

The Difference AI Makes


Reduction in Contract Loading Time 


Reduction in Claims Interest Payment  


Reduction in Claim Adjustment Rate 


Improvement in time to update Directories 


Reduction in Administrative Costs

Inside Provider Contract Management

Smarter, Faster Provider Contract Processing with AI

Digitize Contracts

Our solution digitizes contracts by ingesting and analyzing data from varied formats and sources, simplifying extraction and reducing complexities related to multiple contract types and formats.

Extract Contract Data

The system adeptly extracts crucial data like demographics, rates, terms, and codes, reducing manual errors and enhancing accuracy in provider information and pricing configuration.  

Data Quality Checks

Our solution ensures robust data integrity through customizable, market-specific quality checks, tailored to various source requirements and risk thresholds. 

Data Validation

This feature flags discrepancies and validates provider data using a blend of external and internal sources and rules, achieving over 95% accuracy in provider data recommendations.  

Load to Source Systems 

Our system efficiently loads processed and validated data into source systems in required formats, streamlining updates to contract management, provider data & pricing systems 

Take Control Of Your Contracts With AI  

Prior Authorization

Leverage GenAI and Large Language Models (LLMs) to assess prior authorization requests and direct them to clinical staff for prompt interventions. Generate real-time requests for information to enhance…

Coordination of benefits (COB)

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Claims AI

Improve auto adjudication rates and claims quality with real-time intelligent claim edits. Predict and orchestrate potential claim suspensions to reduce and resolve any manual intervention.

Achieve Accurate, Reliable, And Streamlined
Provider Data Management

Try our solution today