REPORT: The 2025 State of Contracting

Contract Intelligence for Healthcare Payers

Build your provider ecosystem with agility, confidence and contract intelligence

The Challenge

Support quality patient care while mitigating risk

Health insurance companies and other healthcare payers like PPOs and HMOs are hyper-focused on containing costs and delivering quality care while maintaining compliance with ever-evolving regulations and emerging payment models. To keep up with regulatory changes, organizations need industry-specific contract intelligence to adhere to best practices, update complex agreements quickly to ensure compliance, and seamlessly onboard new groups and hospitals to address a network’s primary objective of providing outstanding patient care.

The Solution

Contract intelligence tailored to Healthcare Payers

Contract intelligence enables you to unlock the data and information in all your contracts to make better-informed decisions, build stronger business relationships, and adapt quickly to fluctuating market conditions.

Icertis Contract Intelligence is the only solution that automates provider agreement assembly, compliance management, and risk detection—enabling payers to establish, protect, and scale their provider networks quickly. The Icertis platform also enables mass-amend agreements to ensure compliance in a strict regulatory environment. By automating the creation and updating process for complex agreements, including PPA, BAA, and ASA, Icertis enables healthcare professionals to stay focused on delivering high-quality, patient-centered care.

The Icertis Advantage

Build and protect provider ecosystems

Add new network providers and amend existing agreements to ensure dynamic provider contracts meet network and patient needs. Preloaded network provider types, payer agreement templates, and state plans accelerate onboarding velocity.

Build comprehensive provider agreements

Accelerate contract writing velocity

Validate practitioner credentials and automate delegated credentialing

Enable business associate agreements ​to ensure PHI compliance

Be audit-ready with 360-degree reporting

Ensure Compliance and Reduce Regulatory Risk

Featured Case Study

“Our executives have complete visibility into contract information in real-time. Whenever they need a contract, it's a matter of a split second to go into the system and pull it.”
Desha Dyett-Dennis
Product Owner, Healthfirst
  • Negotiate with confidence

    Track obligations and balance risk across the provider ecosystem. Access, review, and share comprehensive provider agreements that coalesce plan-specific exhibits, reimbursement terms, and fee schedules.

    • Identify comparable agreements with similar risks
    • A comprehensive view of all obligations
    • Auto-assign obligation tasks for completion
    • Track obligation adherence and risk mitigation
    • Retrieve attestation documents with a single click​
    • Expose SLA and associated risk
  • Stay on top of regulatory updates

    Ensure compliance and audit traceability with the ability to execute mass amendments in response to regulatory changes. Eliminate manual searches and updates that can consume weeks and even months. In addition, automated workflows enable proper audit tracking.

    • Easily identify agreements requiring updates due to regulatory changes
    • Mass-amend agreements with a single click
    • Automatically trigger updates based on associated regulatory policies and procedures
    • Dynamically route addendum requests
    • Track compliance of Amendment Objection Notice Period
  • Monitor 360° performance

    Translate provider ecosystem data into ​actionable insight. Configurable drag-and-drop dashboards keep your finger on the pulse of the entire provider ecosystem with real-time data.

    • Monitor your provider network with dashboards ​updated in real-time
    • Display a comprehensive overview of the network provider ecosystem
    • Download and share executive dashboards
    • Export unlimited data sets via a single click
    • Generate and expose NPA data files to connect with third-party claims systems
  • Integrate seamlessly with enterprise technology

    Icertis Contract Intelligence for Healthcare Payer integrates seamlessly with business, sales, marketing, and transactional software from the world’s leading vendors, giving you better visibility into—and control of—contract data and information, wherever it resides.

    Learn More About Our Integrations

The Icertis Platform

Achieve Business Agility with Contract Intelligence

Transforming contracts into structured, connected, and on-demand data is just the beginning. Discover the power of intelligent contract creation, automation, and insights to realize the full intent and maximize the value of every contract, clause, and obligation across the enterprise.

Explore the Platform