Digitize documents to streamline processes and workflows
Contract Intelligence drives meaningful value through:
- Digitized contracts that can enable faster pre- and post-payment integrity audits, which helps reduce false positives and increase medical cost savings
- Quick validation of coverage, policies and reimbursement terms that can help reduce denials, provider abrasion and administrative overhead
- Up to 20% improvement in medical cost savings*
Frequently asked questions about Contract Intelligence
Automated contract management solutions can help transform these documents into structured, digitized data that can be easily searched, analyzed and operationalized. This supports greater transparency, standardization and accessibility, helping improve both administrative efficiency and compliance.
Since many provider contracts are stored in disparate systems and contain complex payment terms, manual management becomes tedious and error-prone.
Automated contract interpretation compares claim data against contract terms to verify that billed services match agreed-upon reimbursement rules. This helps to:
- Identify discrepancies
- Flag potential payment inaccuracies
- Proactively correct issues before they escalate
By reducing manual review and error risk, health plans help ensure consistent adjudication and reduce costly rework.
Find out more about how automated contract interpretation is helping health plans identify contract-based errors and overpayments.
Large volumes of unstructured contracts can be converted into machine-readable formats using automated extraction and interpretation tools. This process can help:
- Accelerate clause identification
- Highlight key terms
- Centralize contract data for more efficient management
Digitization of contracts also supports regulatory compliance by verifying the correct terms are applied consistently across claims.
Automated contract-aware tools help prevent errors related to:
- Pricing
- Eligibility
- Authorization requirements
- Timing limitations
- Plan-specific rules
These tools perform real-time checks during claim adjudication, helping reduce denials, minimize rework and support compliance with contract provisions. This aims to improve accuracy and helps maintain strong provider relationships.
Contract intelligence goes beyond basic storage and document administration. It centralizes fragmented materials, may help improve data consistency and provides actionable insights that enhance operational performance.
By digitizing and interpreting contract language, health plans can:
- Make more informed decisions
- Help reduce administrative overhead
- Strengthen payment accuracy
Healthcare payment integrity trends
Article
Learn how we're leveraging AI to help minimize payment errors associated with manual contract reviews.
Article
Explore real use cases for using AI to drive payment accuracy and the effective ways health plans are leveraging these emerging technologies.
E-book
This guide can help you optimize your payment integrity program and achieve savings goals within 12 months.
Complementary solutions
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Identify claim errors and overpayments related to duplicates, coordination of benefits, billing issues and contract administration.
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*2024 internal model projections. Results may vary across health plans and are not guaranteed.