MCheck® ContractsAI

AI-Powered Contract Management Software

Optimize healthcare contract management. Uncover Recurring Patterns | Drive Standardization | Reduce Provider Abrasion

Transform Healthcare Contract Management with Purpose-Built AI

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HOW HILABS AI CONTRACT INTELLIGENCE SOLUTION OUTPERFORMS LEGACY SYSTEMS

Legacy contract systems were built to store documents, not understand them. MCheck® ContractsAI extracts logic, interprets complex clauses, and converts contract language into structured intelligence, unlocking insights traditional CLMs simply can’t provide.

Enhanced Decision Making

Enhanced Decision MakingTraditional vs ContractsAI comparison
TraditionalContractsAI
Slow and manual clause interpretation with static PDFscheck-circle

Users ask conversational questions to get clause-level answers instantly

Higher risk of errors due to inconsistent or subjective reviewscheck-circle

AI insights support consistent contract interpretation

Pricing terms require manual extraction, leading to configurations errorscheck-circle

Automated pricing terms extraction reduces claims configuration errors

Limited search capabilities delay audits, renewals, and negotiationscheck-circle

Auto-generated summaries provide a clear view of contract obligations

WHY LEADING PAYERS CHOOSE HILABS CONTRACT MANAGEMENT SOLUTION

AI-powered contract intelligence that democratizes contract language and directly integrates contract information into downstream workstreams

MCheck ContractsAI Dashboard

IQT - Smart Provider Contract Query Assistant

IQT Answers
Instantly retrieve contract terms by asking natural language questions across contracts, amendments, and related documents. Built on a healthcare-trained LLM, it delivers accurate, human-readable responses with verified source context
Clause Finder
Pinpoint clauses like readmission penalties or rate carve-outs instantly, with highlighted document source evidence for auditability and confidence
Feedback Loop
Capture real-time feedback on answer quality with built-in thumbs up/down scoring to continuously refine accuracy and relevance

Pricing Configuration - AI-Driven Pricing Engine

Automatic Configuration
Automates pricing configuration by extracting rate data elements, assigning agreement IDs, and generating summaries cutting timelines from weeks to minutes
Smart Term Mapping
Maps new contracts to existing configurations using AI-based matching, eliminating repetitive analyst tasks and reducing error rate
Summary Generation
Generates structured, audit-ready contract summaries from full-length PDFs, simplifying pricing data ingestion across downstream systems

Delivering contract intelligence every day across health plan operations

100,000+

Contracts processed across 30+ Markets

50%+

Automation in contract pricing configuration

50%+

Accuracy in contract term extraction and natural language queries

HOW CONTRACTSAI WORKS: FROM CONTRACT CHAOS TO INTELLIGENT AUTOMATION

MCheck® ContractsAI breaks down complex healthcare contracts into their core logic, extracting rules, conditions, and variations with precision. By standardizing language and converting clauses into structured, executable intelligence, the platform enables teams to generate drafts, compare versions, and drive decisions with clarity and consistency.

How MCheck ContractsAI works?

Intelligent Document Ingestion & OCR

ContractsAI begins by ingesting provider contracting documents, including Participating Provider Agreements (PPAs), rate sheets, amendments, fee schedules, and regulatory attachments.

Advanced layout detection + OCR converts scanned or unstructured documents into machine-readable text.

Content is broken into logical contract chunks and stored in a vector database for high-precision retrieval and clause-level reasoning.

This foundation enables consistent interpretation across contract types and markets—which traditional CLM tools cannot provide.

AI-Driven Data Extraction & Pricing Configuration

Next, ContractsAI applies healthcare-specific AI models to extract the following, while leveraging automation capabilities (e.g., automated pricing configuration, clause extraction, and detection of non-standard terms), the system converts extracted terms directly into claims-ready pricing configurations, reducing the manual setup time that traditionally takes much longer

Reimbursement terms

Modifiers and rate IDs

Delegated responsibilities

Required CMS/NCQA clauses

Termination rights

Compliance language, and more.

Agreement ID Assignment & Configuration

Once pricing terms and obligations are extracted, ContractsAI:

Assigns agreement IDs using standardized logic

Maps contract attributes to the appropriate fee schedules, provider groups, and TINs

Finalizes the agreement configuration ensuring alignment with adjudication systems (like FACETS or QNXT)

This eliminates downstream inconsistencies that lead to overpayments, underpayments, and costly appeals.

Open-Ended Q&A With Intelligent Query Tool (IQT)

Users can ask real questions such as:

“What are the termination rights for this provider?”

“List all groups with shared savings arrangements in Arizona.”

ContractsAI returns evidence-backed answers using clause-level retrieval capabilities.

Healthcare teams no longer waste hours searching for PDFs, email chains, or SharePoint folders.

Interactive UI for Clause Insights & Summaries

This interface brings transparency to complex provider agreements and reduces SME dependency. The platform presents all extracted terms in a clean, intuitive UI, allowing teams to:

View clause summaries

Compare contract versions

Identify non-standard or high-risk language

Validate compliance alignment

Export insights for negotiations or auditing

Downstream Automation for Claims & Pricing

ContractsAI pushes validated pricing outputs directly into downstream systems, supporting claims processing, reimbursement accuracy, and configuration consistency. This closes the loop between contract language and operational execution—one of the biggest gaps identified in today’s CLM tools.

Rules Engine & Continuous Feedback Loop

As teams interact with the platform, ContractsAI learns over time, improving extraction accuracy, pricing automation, clause detection, and natural-language Q&A. A powerful rules engine allows health plans to define

Business rules

Pricing logic

Clause benchmarks

Compliance thresholds

PROVEN RESULTS: HOW CUSTOMERS ACCELERATE ACCURACY, SPEED, AND INSIGHT WIITH CONTRACTSAI

MCheck ContratcsAI_Case study section_.png

95%+ Information Retrieval Accuracy

IQT automates manual tasks by instantly surfacing key contract terms such as reimbursement rules and exceptions through simple natural language queries

90-Day Contract Pricing Backlog Reduced to Minutes

ContractsAI achieved >80% automation in pricing term mapping and agreement ID assignment accelerating pricing configuration and freeing analysts from manual, error-prone tasks

Actionable Insights and Summaries from Across Contracts

ContractsAI flagged inconsistencies in reimbursement terms and rules generating audit-ready summaries and removing the need for line-by-line manual reviews

ALWAYS-ON SUPPORT FOR CRITICAL HEALTHCARE OPERATIONS

  • Expert support to ensure smooth onboarding and sustained operational success
  • Dedicated, proactive issue resolution to minimize disruptions and maintain continuity
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HEALTHCARE DATA MANAGEMENT SOLUTIONS, BUILT FOR SCALE

Purpose-built platforms that bring accuracy, intelligence, and automation across provider data, networks, contracts, value-based care, and clinical operations.

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MCheck Roster Automation

Truly touchless end-to-end roster automation

MCheck Directory Accuracy

MCheck Directory Accuracy

AI that replicates Healthcare SME behaviour—at scale—to correct and enrich directory data

MCheck NetworkIQ

MCheck NetworkIQ

AI to optimize network management: Compliance, Competitiveness, and Cost of Care

MCheck Value Based Care

MCheck Value Based Care

Ensuring payment and data integrity in Value-Based Care

MCheck Clinical

MCheck Clinical

Advanced AI tailored for healthcare to extract critical clinical data

MCheck® ContractsAI: Frequently Asked Questions (FAQs)

Healthcare contracts can be complex. These FAQs break down how HiLabs simplifies contract interpretation, enhances consistency, and integrates trusted intelligence into day-to-day workflows.

What is contract lifecycle management in healthcare?

Contract lifecycle management (CLM) in healthcare is the end-to-end process of creating, negotiating, executing, implementing, and monitoring provider contracts. Robust CLM ensures reimbursement accuracy, regulatory compliance, and smooth integration with claims and operational systems.

What are the 5 stages of healthcare CLM?

Healthcare CLM typically includes contract creation & intake, review & negotiation, approval & execution, implementation & pricing configuration, monitoring, audits & renewal

What is the difference between contract management systems and contract lifecycle management (CLM)?

A contract management system centralizes storage and workflow tasks, while CLM manages the full lifecycle, including clause validation, pricing setup, audit readiness, and compliance monitoring. Healthcare requires true CLM, not just document storage.

What makes MCheck® ContractsAI different from traditional CLM systems?

ContractsAI uses healthcare-trained AI to extract pricing terms, detect non-standard clauses, automate agreement ID assignments, and deliver audit-ready insights. Unlike generic CLMs, it offers cross-document intelligence, natural-language Q&A, and automated downstream configuration.

Does ContractsAI support provider contract standardization?

Yes. ContractsAI benchmarks clauses against approved templates, flags non-standard language, and recommends standardized terms to reduce risk and improve contract consistency.

Can ContractsAI integrate with existing payer systems and workflows?

Yes. ContractsAI integrates with provider directories, claims platforms (FACETS, QNXT), credentialing systems, workflow tools, and data lakes via secure APIs. It fits into payer contracting, network, compliance, and cost-of-care workflows without disruption.

Is ContractsAI suitable for complex value-based care (VBC) agreements?

Yes. ContractsAI supports extraction and validation of VBC terms including shared savings, bundled payments, quality metrics, and delegated arrangements. It also models risk-bearing obligations and financial scenarios.

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