Healthcare Contract Management

Collect payer underpayments quickly and efficiently

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Jessica Marple from PeaceHealth Medical Group discusses how they improved payer relationships and reached a return on investment of $3.8 million over 5 years with Contract Manager. 

Perform contract auditing and analysis to gain visibility into payer contract reimbursements and performance. Confidently report and negotiate new payer agreements.

Unfortunately, missed payer payments and underpayments happen. Identifying and correcting these inaccurate payments often falls to healthcare providers. These errors can cause stress and volatility to your revenue cycle.

Simple human error is the main reason why medical claims are denied. The smallest typo or discrepancy can lead to an immediate denial, and reworking a claim rarely increases its chance of being more accurate. Streamline claims management by checking that every claim is clean and error-free before it is submitted. Fewer denials and reworked claims mean a faster and more predictable revenue cycle, as well as lower administrative costs and more time for staff to focus on patient care.

You need automated access to the right data. Our solutions help you get reimbursed accurately and quickly, while strengthening your relationships with payers.

Scripps Clinic client success story

Learn how $10.6 million in underpayments was recovered in 9 years.

Payer contract management for Medical Groups, Hospitals and Health Systems

Let us help you make sense of the growing volume and complexity of payer contracts and gain leverage when negotiating with payers. Now you can perform reporting and business intelligence with ease.

Validate reimbursement accuracy

Recover underpayments

Manage and execute appeals

Manage claims status

Evaluate contract results

Negotiate favorable terms with payers

Streamline and simplify workflow processes

Contact our team to get started

Learn more about our contract management solutions

Automated Healthcare Payer Alerts

Avoid payment delays and lost revenue with automated payer policy and procedure change notifications.

Contract Manager and Analysis

Audit payer contract performance to assure compliance—and maximize revenue.

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More information about Experian Contract Manager

Hospitals & Health Systems

  • Powerful multi-payer claims valuation engine so every claim is priced on your terms
  • Valuation is performed at the claim level, considering rules such as stop-loss, case rates, carve-outs and multiple grouper methodologies
  • Monitor reimbursement using online dashboards and reports

Medical Groups

  • Our team of contract analysts defines and maintains your contract terms, fee schedules, carve-outs and payment policies
  • Reimbursement is monitored without involving IT thanks to online dashboards and reports
  • Payment discrepancies are reduced with Power Reporting, which provides revenue cycle intelligence and interactive graphs

Duke Private Diagnostic Clinic partners with Experian to evaluate contacts and ensure they are being paid appropriately. They can now identify system issues that could result in underpayments.

The University of Iowa Hospitals & Clinics saved time and money implementing a contract management system that allows them to monitor payer compliance and audit remittances based on latest payment rules and adjudication logic. 

Contract management resources

Best in KLAS 2020

Category Leader: Contract Management

The secret to decoding insurance payments and contracts

Keeping up with payer alerts

Collect every dollar due

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1 888 661 5657

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