Understanding contract management for healthcare
Key takeaways:
- Contract management in healthcareis 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’sContract Managerhelp 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 for32% of denialsin 2025.
