Product Sheet

Contract Manager for hospitals and health systems

verifies contractually allowed amounts for all applicable

claims, monitors payer compliance with contract terms, and

models the financial implications of proposed contracts.

Contract Manager’s remote data processing and storage

provides secure, 24/7 web-based access with no capital

investments and no added cost for software or data

updates.

carve-outs and payment policies within the system

using a powerful multi-payer claims valuation engine so

every claim is priced according to your terms

• Accurately adjudicates claims and compares expected

payment to actual reimbursement

• Valuation is performed at the claim level, taking into

account complicated rules such as complex stop-

loss, case rates, carve-outs and multiple grouper

methodologies including DRG-based reimbursement

• Identifies contractual appeal opportunities so you

payer contract negotiations armed with data

to boost reimbursement and avoid costly rule

changes using your own claims history to run

a variety of contract modeling scenarios.

Contract Manager and Contract Analysis

for Hospitals & Health Systems

Managing your payer contracts doesn’t have to be time consuming or complicated. Experian Health has the

expertise and resources to help you simplify the process and ensure you are reimbursed quickly and accurately.

Simplify contract management by letting us do the heavy lifting

What you get

Works well with

Contract Manager for Hospitals & Health Systems is often

used in combination with other Experian Health solutions

platform.