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Every agreement. Every member. 

Healthcare payer contracts govern provider networks, employer relationships, and regulatory obligations that affect millions of members. Make every agreement perform.

Key Benefits
Use Cases
How We Deliver
Customer Stories
Resources
Icertis in Action

Agreements that drive outcomes

Connect contract terms to network performance, employer retention, and operational results so every agreement delivers value.

Full network visibility

Track reimbursement models, provider obligations, and network requirements across your entire payer ecosystem in one place.

Regulatory confidence, built in

Map CMS, Department of Insurance (DOI), and Medical Loss Ratio (MLR) requirements to contract clauses and track compliance consistently.

Vendor accountability at scale

Track SLAs, delegated service commitments, and performance requirements across all agreements.

Provider network management

Manage provider agreements, reimbursement models, and value-based arrangements with clause-level visibility.
  • Track fee-for-service rates, reimbursement schedules, and value-based care terms across provider agreements.
  • Surface amendments, participation requirements, and credentialing obligations before they impact network obligations.
  • Improve decision-making with structured provider contract data that supports network performance.

Employer & ASO management

Centralize employer and Administrative Services Only (ASO) agreements to strengthen consistency and operational control.
  • Track renewal timelines, rate guarantees, and performance commitments across your full employer book of business.
  • Track service-level obligations and settlement terms so employer accounts receive what their contracts promise.
  • Identify at-risk accounts by surfacing expiring agreements, unmet guarantees, and open amendments before renewals.

Delegated services & vendors oversight

Hold Pharmacy Benefit Managers (PBMs), Third-Party Administrators (TPAs), and delegated partners accountable for contractual performance.
  • Track SLAs, performance thresholds, and penalty triggers across every delegated services partner.
  • Surface underperformance and SLA deviations before they create downstream risk for members or regulators.
  • Monitor vendor compliance with reporting requirements, regulatory pass-through provisions, and operational obligations.

Compliance & audit readiness

Track CMS, DOI, and MLR obligations at the contract level, so audits and reviews don’t become fire drills.
  • Map regulatory requirements to specific contract clauses and maintain evidence trails across every obligation.
  • Respond to regulatory changes with instant visibility into every affected provider, employer, and vendor agreement.
  • Maintain audit-ready documentation across multi-jurisdictional compliance requirements without manual tracking.

Move from contract creation to compliance to insight, without gaps

Customer Stories

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How Healthfirst Streamlined Provider Contract Management with Icertis

Discover how Healthfirst, a leading health insurance provider, improved contract visibility, automation, and compliance by centralizing provider relationships with the Icertis platform, enhancing efficiency across Medicaid, Medicare, and commercial markets.

Desha Dyett-Dennis

Resources

Insights for healthcare payer contract and compliance leaders.

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Join 400+ enterprises who've made contracts their competitive advantage.

See Icertis in action

See how Icertis Contract Intelligence connects agreements, data, and systems across your payer organization.

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