CAREPACT AI
Policy Changes → Contracts → Claims

Payer policies change quietly.
Your revenue shouldn't.

CarePact AI continuously watches payer policy changes, traces their effect through your contracts to every claim they touch, and hands your team an evidence-backed queue of what's owed — before it becomes lost revenue. And when it's time to renegotiate, its contract negotiation engine puts industry-best clauses on your side of the table.

Request a demoSee how it works
Work Queue · Variances · 4 of 128 shown$838.72 recoverable on screen
CPT 99285
ED visit, high complexity
$742.00
$531.18
-$210.82
Atlas
CPT 70553
MRI brain w/ & w/o contrast
$1,284.00
$1,284.00
$0.00
Meridian
CPT 29881
Knee arthroscopy
$3,110.00
$2,488.00
-$622.00
Northwind
CPT 80053
Comprehensive metabolic panel
$47.00
$41.90
-$5.10
Atlas
Evidence attachedContract §4.2 fee schedule · Line 118•Remit 835 · CLP07 trace•Rate escalator 3.5% (eff. 01/2026)Export dispute →
Our story

Reimbursement shouldn't require a forensic audit.

Payer policy changes land in bulletins nobody has time to read. Contract terms live in PDFs. Claims live in your billing system. Every misalignment between the three costs providers money — usually quietly, usually for months. CarePact AI was built to close that gap: to watch every policy change the moment it lands, trace it through your contract language to every claim it touches, and flag the revenue at stake with the paperwork to prove it. And when a contract comes up for renewal, its negotiation engine arms you with industry-best clauses — so the next agreement starts on your terms.

Solutions

From policy change to closed dispute to a stronger contract, in one pipeline.

Nine connected capabilities that turn payer bulletins, a filing cabinet of contracts, and a flood of remits into a single, prioritized list of what to act on next — and a stronger hand at your next negotiation. Scroll — each stage opens as you reach it.

01Payer Policy Watcher

We continuously track policy bulletins for the payers you choose to watch, and surface every change the moment it lands — before it quietly shows up as denials or reduced payments.

02Policy-to-Contract-to-Claims Impact Map

Trace a single policy change through your contract language to every past and future claim it touches — with the dollar impact quantified before it costs you anything.

03Contract Ingestion & Rate Extraction

Upload payer contracts as PDFs, scans, or amendments. We parse fee schedules, carve-outs, and escalators into structured, queryable rate tables — no manual re-keying.

04Expected Reimbursement Engine

Every claim is priced against the governing contract the moment it's submitted, so you know what a payer owes before their remittance ever arrives.

05835 / Remit & Claims Batch Ingestion

Bulk-load 835 remittances and claims files in one pass. Each line is automatically matched back to the contract clause that should have priced it.

06Contract-to-Claim Variance Detection

See exactly where a payer underpaid and by how much — down to the fee schedule line, the CPT code, and the dollar amount at stake.

07Evidence-Backed Work Queue

Every variance and policy impact lands in one prioritized queue with the contract clause, claim detail, and dollar amount already attached and ready to dispute.

08Action-Ready Exports

Push disputes, appeals, and reporting packages out in the exact format your payer portal, clearinghouse, or EHR expects.

09Contract Negotiation Engine

Turn everything CarePact has learned — policy shifts, underpayment history, unenforced clauses — into negotiation-ready amendment language with industry-best clauses, so your next contract doesn't leak revenue.

Capabilities

Built for both sides of the payment.

The same underlying engine, aimed at two different jobs — recovering what's owed, or proving what was paid correctly.

For Providers

Stop losing revenue to contract drift. Know within a billing cycle — not a year-end audit — where a payer's remit doesn't match the contract you signed.

  • →Catch underpayments claim-by-claim, not in a retrospective sample
  • →Get ahead of payer policy changes before they hit your AR
  • →Hand billing staff a queue with the evidence already attached
  • →Export disputes in the format each payer portal accepts
Variance surfaced per claim batch1–3% of billed
Time to first flagged variance< 24h
Contract clauses tracked1,200+

Figures shown are directional. Real ranges shared under NDA in your demo.

Security & Trust

Your claims data never leaves a locked room.

CarePact AI handles PHI, 835s, and signed contracts — so security isn't a feature, it's the foundation. Encrypted in transit and at rest, least-privilege access, and full audit logging on every record.

Read our security posture →
SOC 2 Type II
in progress
HIPAA aligned
attested
HITRUST
roadmap
Encryption at rest & in transit
live

confirm each compliance status before launch — do not overstate certifications

Insights

We speak fluent contract, claim, and mandate.

Where healthcare reimbursement meets the transparency era — read how the details move the dollars.

Guide

Reading a payer contract the way a payer's system reads it

Why the gap between contract language and adjudication logic is where the money leaks.

Teardown

One escalator clause, three years, six figures

A walk-through of how a single missed rate escalator compounds across a claim book.

Regulatory

Price transparency mandates and your AR

What CMS transparency rules and the No Surprises Act change for reconciliation workflows.

See your own contracts run through it.

Bring one payer contract and one batch of claims. We'll show you the variance in your first call.

Request a demoSee a sample variance report