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Understanding contract management for healthcare Key takeaways: Contract management in healthcare is about negotiating, executing and monitoring agreements so providers can check that they are being paid in line with their contracts. Managing contracts across hundreds of payers and changing regulatory requirements is complex. Automation, AI and analytics can streamline contract oversight and identify discrepancies earlier. Tools such as Experian Health’s Contract Manager help providers audit payer performance, flag underpayments and manage contracts more efficiently across the contract lifecycle. The front-end data problem behind claim denials Experian Health surveyed 200 healthcare leaders from January to February 2026 to better understand the reasons for claim denials and opportunities for improvement. What are eligibility-related claim denials? Eligibility-related claim denials happen when a payer denies a claim submission for reimbursement due to patient insurance issues. Inaccurate or missing patient insurance information is a top denial trigger and often starts at the front end, during registration. Evolving payer eligibility requirements and new regulatory mandates also make it challenging for providers to avoid eligibility issues that can lead to denials. The most common causes of eligibility errors in healthcare billing 1. Mistakes made during patient intake: Eligibility-related issues often begin during patient intake – especially when providers use manual registration processes, like paper forms. Incorrect patient information entered on the front-end can cause eligibility issues that lead to billing mistakes, reimbursement issues and denials. Experian Health data shows that incomplete or missing insurance patient registration data is a top cause of claim denials, accounting for 32% of denials in 2025.
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Experian Health is very pleased to announce that we’ve ranked #1 in the 2025 Best in KLAS: Software & Services report, for our Contract Manager and Contract Analysis product, for the third consecutive year. Contract Manager, when paired with Contract Analysis, empowers healthcare providers by ensuring payers comply with contract terms, identifying and recovering underpayments, and arming them with real claims data to negotiate contracts. This enables providers to negotiate more favorable terms and maintain financial stability. Clarissa Riggins, Chief Product Officer at Experian Health, says, “In the ever-evolving healthcare landscape, our Contract Manager solution has once again been recognized as the #1 Revenue Cycle Management tool by KLAS for the third consecutive year. This prestigious ranking underscores the significant value our solution delivers to our clients by identifying underpayments and facilitating revenue recovery. We are honored to continue supporting our clients with innovative solutions that drive financial success and operational efficiency.” Learn more about how Contract Manager and Contract Analysis can help your healthcare organization validate reimbursement accuracy, recover underpayments and boost revenue. Learn more Contact us
Learn how providers can increase patient engagement, why it matters and key strategies that deliver improved end-to-end patient experiences.
Traditional revenue cycle management strategies are on shaky ground. This revenue cycle management checklist can help find opportunities.
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