Common challenges.

Today’s healthcare payors and providers operate in an ever-changing, complex regulatory and commercial environment. In order to stay competitive and compliant, these organizations need to be able to react quickly to changing laws and foster close collaboration with third-party business partners. Key to responding to these imperatives are contracts.

If left unaddressed, these challenges can lead to legal liability, leakage in the form of incorrect billing or reimbursement, high procurement costs and poor patient experiences.

In working with some of the world’s largest healthcare organizations—both payers and providers—Icertis has identified a number of common challenges:

  • Manual management of complex agreements between payers and providers is time-consuming and error-prone, especially for Physician Participation Agreements that contain provider details, program details, large volumes of reimbursement terms, participating locations, etc.
  • Business Associate Agreements (BAAs) required by law are cumbersome to initiate and verify, slowing the contracting process
  • Claims, disputes and change requests are impeded by a lack of self-service capabilities on agreements
  • Inability to take bulk actions like mass amendments on large volumes of contracts
  • Complex Administrative Service Agreements between providers and employers are difficult to create and maintain
  • Large volumes of procurement contracts for products and services at hospitals and clinics are difficult to assess for optimization and must support OpenRFx to push details to supplier portals

The Icertis solution.

Icertis has implemented Contract Lifecycle Management (CLM) solutions for some of the world’s largest healthcare payors and providers, leveraging the Icertis Contract Intelligence (ICI) platform combined with our powerful suite of applications.

While the ICI solution is ultimately configured for each customer, our CLM for healthcare capabilities include:

Functionality to execute bulk actions including mass amendments on Physician Participation Agreements to quickly respond to high volumes of regulatory or commercial changes

of required BAAs before contracts are completed and auto-initiation of BAAs in cases where they are missing

to allow stakeholders to submit requests for amendments, new contracts and disputes

Full source-to-contract functionality to optimize direct and indirect procurement

Icertis’ healthcare solutions offer unmatched benefits across the entire enterprise. We handle all contract types, have integration adapters for other enterprise systems, and can ensure that companies continue to maximize the value of their contracts long after each one is signed.


Enterprise Contract Management for the Healthcare Industry: An Industry Overview

With the Icertis Contract Intelligence (ICI) platform, healthcare payors and providers can ensure full compliance in a strict regulatory environment and enable seamless contract collaboration between insurers, physician groups and other stakeholders.

See more resources.