Healthcare Contract Intelligence OS

The intelligence layer for healthcare contract economics.

Turn healthcare contracts, negotiated rates, claims, remits, and reimbursement data into actionable intelligence for benchmarking, negotiation, and revenue recovery.

Request a DemoExplore the Platform
Contracts
Negotiated Rates
Claims + Remits
Benchmarks
Contract Intelligence Control Plane
Active Model
Governed Reimbursement Intelligence
01
Contracts
02
Negotiated Rates
03
Claims + Remits
04
Benchmarks
05
AI Workflows
Decision Output
Benchmarking context
Negotiation leverage
Underpayment detection
Revenue recovery
The Problem

Healthcare has digitized transactions. It has not digitized contract intelligence.

Payer contracts, MRF files, claims, remits, fee schedules, and reimbursement policies are fragmented across systems and manual workflows. The result is weak negotiation visibility, slow analysis, underpayment risk, and lost financial leverage.

Why This Breaks Leverage
Fragmented reimbursement signals create slow decisions and hidden financial exposure.

Healthcare organizations can process transactions at scale, but the intelligence needed to interpret contracts, validate payments, and negotiate from strength is still scattered across files, systems, and manual workflows.

Risk Vector 01
Fragmented contract data
Contracts, fee schedules, and reimbursement policies remain disconnected from the systems teams use to act.
Risk Vector 02
Manual reimbursement analysis
Critical contract economics still depend on spreadsheet-heavy interpretation and repeated human review.
Risk Vector 03
Weak payer negotiation visibility
Without governed market and payment context, negotiation teams lack fast clarity on where leverage exists.
Risk Vector 04
Revenue leakage risk
Missed variance, weak benchmarking, and slow escalation create preventable margin loss over time.
The Shift

From price transparency to contract intelligence.

Transparency created data access. But data alone does not create leverage. Healthcare organizations need a governed intelligence layer that connects what was negotiated, what was paid, how the market compares, and what action to take next.

Old World
Data access without decision leverage.
01Static MRF files
02Manual spreadsheets
03Disconnected contracts
04Slow reimbursement analysis
New World
Governed intelligence that moves teams to action.
01Governed rate intelligence
02Contract-aware benchmarking
03Claims-to-contract validation
04AI-guided negotiation workflows
Platform Overview

A new operating system for healthcare contract economics.

A governed intelligence layer that connects fragmented reimbursement inputs into structured analysis, benchmarking context, and decision-ready workflows.

System Model
Govern the flow from fragmented reimbursement inputs to financial decisions.

The platform is designed as a layered operating system, turning raw healthcare contract and reimbursement artifacts into structured intelligence, benchmark context, and action-ready workflows.

Governed inputs across contracts, rates, claims, and remits
A strategic layer between raw data and financial action
1
Data Foundation
Normalize fragmented reimbursement inputs into a dependable base layer for analysis.
2
Contract Intelligence Graph
Connect contracts, rates, claims, and policies into structured relationships that preserve context.
3
Benchmarking + Analytics
Turn raw reimbursement complexity into benchmarkable, comparable financial signals.
4
AI Agents
Apply governed automation where review, comparison, and reasoning accelerate decision-making.
5
Workflow + Decisions
Push intelligence into the workflows where pricing, negotiation, and recovery decisions actually happen.
MRF Autopilot

Start where the data problem is hardest.

MRF Autopilot ingests, normalizes, governs, and benchmarks massive machine-readable rate files, transforming messy transparency artifacts into structured financial intelligence.

Wedge Flow
The wedge is practical by design: solve the hardest reimbursement data problem first, then expand into broader contract intelligence workflows.
1
MRF Files
2
Normalization Engine
3
Governed Rate Intelligence
4
Benchmark Outputs
Capability 01
Discover payer transparency files
Capability 02
Normalize negotiated rates
Capability 03
Govern lineage and provenance
Capability 04
Benchmark CPT-level economics
Capability 05
Prepare expansion into contract intelligence
Radiology Wedge

Focused wedge. Fast proof of value.

Radiology is a compelling first entry point because it is CPT-driven, high-volume, reimbursement-sensitive, and benchmark-friendly. It gives the platform a focused path to demonstrate ROI before expanding into broader specialties.

Why Radiology First
A focused commercial entry point with fast feedback loops.
This is a commercial proving ground, not a clinical detour: dense CPT economics, meaningful payer variation, and fast benchmarking feedback loops make radiology a strong first market.
Specialty Signal 01
CPT-driven reimbursement
Specialty Signal 02
High commercial volume
Specialty Signal 03
Benchmark-friendly rate structures
Specialty Signal 04
Strong payer negotiation relevance
AI Agents

AI agents that turn reimbursement analysis into action.

PactGrid does not stop at dashboards. Governed AI agents help teams review contracts, benchmark rates, validate claims, identify leakage, prepare payer negotiations, and generate executive-ready insight.

Agent 01
Contract Review Agent
Summarizes payer terms, extracts reimbursement logic, and highlights contract risks.
Agent 02
Rate Benchmark Agent
Compares negotiated rates across payers, plans, CPT codes, markets, and specialties.
Agent 03
Claims Validation Agent
Compares actual payments against expected contract logic to surface mismatches.
Orchestration Layer
Contract Intelligence Core
Governed agents stay anchored to structured reimbursement intelligence instead of drifting into generic automation.
Agent 04
Revenue Leakage Agent
Detects underpayment patterns, reimbursement drift, and recovery opportunities.
Agent 05
Negotiation Prep Agent
Creates payer-specific evidence packs for renewal, renegotiation, and strategic discussions.
Agent 06
Executive Insight Agent
Converts complex reimbursement data into clear financial narratives for leadership.
Business Outcomes

Built for financial advantage.

PactGrid helps teams move from fragmented reimbursement data to measurable financial action.

Executive Framing
The goal is not another analytics layer. The goal is faster financial decisions with clearer leverage, better visibility, and less manual analysis drag.
Executive Outcome 01
Faster rate benchmarking
Executive Outcome 02
Stronger payer negotiations
Executive Outcome 03
Underpayment detection
Executive Outcome 04
Revenue recovery
Executive Outcome 05
Reduced analyst burden
Executive Outcome 06
Better contract visibility
Who It's For

Designed for healthcare financial decision-makers.

The platform is built for teams responsible for understanding reimbursement, improving contract economics, and turning fragmented healthcare financial data into action.

Buyer Lens
Built for the people making reimbursement and contract decisions.
This is not broad healthcare messaging. The platform is designed for the operators, finance leaders, and advisors who need reimbursement clarity, economic leverage, and faster strategic decisions.
Audience 01
Provider CFOs
Focus: Margin visibility, reimbursement performance, payer economics.
Audience 02
Revenue Cycle Leaders
Focus: Underpayment detection, claim validation, recovery prioritization.
Audience 03
Managed Care / Contracting Teams
Focus: Rate benchmarking, renewal strategy, payer negotiation prep.
Audience 04
Specialty Groups / MSOs
Focus: CPT-level rate visibility, payer comparison, specialty economics.
Audience 05
Healthcare Advisory Firms
Focus: Faster analysis, evidence packs, benchmark-driven client recommendations.
Audience 06
Payers / TPAs / Employers
Focus: Network economics, negotiated rate intelligence, market comparison.
Request a Demo

Turn healthcare contract data into financial leverage.

Understand what was negotiated, what was paid, how it compares to the market, and what action to take next.

Next Step
Start the conversation around benchmarking, negotiation leverage, and recovery workflows.
Request a Demo