Payer contracts are complex, inconsistent, and constantly changing. CIVIE brings intelligence to the negotiation process by automatically analyzing payer behavior, identifying contract variances, and surfacing underpayments—so your team negotiates with data, not guesswork.
Radiology groups and healthcare providers operate under hundreds of payer contracts—each with unique rate structures, carve-outs, modifiers, and exceptions. Manual reviews can’t keep up. Underpayments go unnoticed, disputes lack evidence, and negotiation cycles drag on for months with limited leverage. The result is silent revenue leakage and inconsistent payer accountability.
CIVIE Contract Negotiations transforms static payer agreements into living data models. By combining contract terms, claims behavior, and payment outcomes, CIVIE continuously evaluates payer performance and highlights negotiation opportunities in real time.
Digitize payer contracts into structured, machine-readable models—capturing rates, modifiers, thresholds, and exceptions for automated comparison.
Identify underpayments, incorrect reimbursements, and deviations from contract terms automatically—across all payers and plans.
Surface payer-specific trends, leverage points, and historical outcomes to support data-backed negotiation strategies.
The system evolves with every adjudication, appeal, and settlement—refining models as payer behavior changes.
CIVIE embeds contract intelligence directly into the revenue lifecycle—turning every claim into actionable negotiation insight.
Contracts are ingested, normalized, and converted into structured logic that reflects real-world payment rules—not just written terms.
As claims are adjudicated, CIVIE continuously compares expected vs. actual reimbursement to identify discrepancies instantly.
Negotiation teams access dashboards that quantify financial impact and arm discussions with objective, defensible data.
Contract Negotiations is natively connected to CIVIE’s revenue and analytics platforms—ensuring insights flow directly into operations.
Detect underpayments and enforce contract compliance automatically.
Visualize payer performance, contract leakage, and negotiation outcomes.
Ensure upstream accuracy before contract evaluation begins.
Validate deposits against contracted expectations in real time.
Organizations using CIVIE Contract Negotiations gain clarity, confidence, and leverage—resulting in faster resolutions and measurable financial impact.
Find answers to your key questions about CIVIE. Whether you want to dive deeper into how our technology works or better understand how it can fit into your business, we have the answers you need.
Are you ready to improve operations, boost job satisfaction, and give your patients a better experience. CIVIE delivers all those advantages and more. Let’s talk.
