Payer contract management
Know what’s in your payer contracts — and what it’s really worth
AI reads your contracts, extracts the terms that matter, and calculates the dollar rate behind fee schedule references, so your team can negotiate from a position of strength instead of digging through PDFs.
Powering 300+ healthcare organizations to scale
Turn dozens of PDFs into a searchable, negotiation-ready system of record
Payer contracts are usually scattered across shared drives, email threads, and whoever negotiated the deal three years ago. Medallion centralizes contracts, uses AI to pull out the terms teams get asked about, and surfaces the implied rate hiding inside fee schedule references.
01
Centralized contract repository
Upload contracts one at a time or in bulk, and filter or export by payer, line of business, state, status, and effective date.
02
AI-assisted key-term extraction
AI extracts effective dates, renewal windows, timely filing limits, payer contacts, and exclusions into structured fields on upload, with your team reviewing what’s captured.
03
Implied rate calculation
See the dollar rate behind fee schedules and percentage-of-Medicare references, down to the code level.
04
Payer-level rollups
View contracts with a given payer rolled up automatically across clinic brands, TINs, and groups.
- 1 sourcefor your payer contracts, tied to your provider and payer records
- 3 embedded agentsto retrieve contract data, model rate changes, and prepare for renegotiation
- 1 viewto compare rates across payer contracts, normalized to the same benchmark
One system for each stage of the contract lifecycle
01
Intake
Upload a single contract or drop in your whole repository as a .zip file.
02
Extraction & review
AI extracts key terms and generates a plain-language summary that flags risks and opportunities.
03
Ongoing management
Track effective dates and renewal windows, compare rates across contracts, and model proposed rate changes before you ask for them.
Built for the complexity of real payer contracts
Structured terms from unstructured contracts
Effective dates, renewal and renegotiation windows, timely filing limits, contract type, payer contacts, and narrow-network exclusions are extracted into structured, searchable fields.
Risk and opportunity flagged automatically
An AI-generated summary calls out things like a rate-reduction clause tied to a data requirement, so important provisions are less likely to stay buried in page 40 of a PDF.
Model rate changes before you negotiate
Test a proposed change against your own contract data to see the estimated revenue impact.
See the calculated rate behind contracts
Implied rate calculation
Most contracts don’t list a dollar rate — they reference a fee schedule. Medallion identifies the reference and automatically calculates the actual dollar rate per code.
Current fee schedules, automatically
Publicly available fee schedules refresh on a set cadence; if a fee schedule isn’t public, your team can upload it. Rates account for differences by provider type and by code.
Side-by-side comparison and forecasting
Compare fee schedules and contract terms across payers from any table, and model the estimated revenue impact of a proposed rate change before you ask for it.
Your questions answered
Payer contract management software centralizes a healthcare organization’s payer contracts and makes their terms searchable, so teams can find rates, effective dates, and filing limits without opening each PDF. Medallion adds AI-assisted extraction of key terms for your team to review, along with implied rate calculation behind fee schedule references.
Many payer contracts reference a fee schedule, often as a percentage of Medicare, rather than listing a dollar amount. Finding the rate means identifying the referenced schedule and calculating the per-code amount from it. Medallion identifies that reference and calculates the implied per-code rate, accounting for provider type and code.
Each extracted field is editable inline. AI handles the initial extraction and summary so your team doesn’t start from a blank page, and your team keeps final review and correction over what’s captured.
Contracts with the same payer often sit under separate TINs, clinic brands, or acquired groups, which makes comparison difficult. Medallion rolls those contracts up by payer and by group, so you can compare terms and fee schedules in one view instead of reviewing one contract at a time.