Resources

Turning Contract Library into Executable Contracts

Most payer contract libraries improve visibility but fail at execution. This paper explains how transforming static provider contracts into executable, clause-level logic helps eliminate contract drift, strengthen audit defensibility, and unlock real financial control across pre-pay, post-pay, and contract negotiations.

The MLR Imperative: $6B Cost Containment Through Intelligent Medical Expense Management

This paper examines how rising medical loss ratios (MLR) are pressuring payer margins and why traditional cost controls are no longer enough. It highlights how intelligent, AI-driven medical expense management can unlock billions in savings by improving accuracy, accountability, and spend governance.

The Trust Imperative: Defensive AI Strategy for Healthcare Payers

As AI adoption accelerates, this paper outlines why trust, transparency, and control are non-negotiable for healthcare payers. It presents a defensive AI framework that prioritizes explainability, governance, and compliance while still delivering measurable impact in payment integrity and cost containment.

Trust at Speed: Neuro-Symbolic AI for Prior Auth, Pre-Pay Adjudication, and Post-Pay Integrity

This paper explores how neuro-symbolic AI enables healthcare payers to make faster, more accurate authorization and payment decisions without sacrificing trust or auditability. It explains how combining AI-driven understanding with deterministic logic helps reduce leakage, prevent denials, and ensure explainable outcomes across the payment lifecycle.

Neuro-Symbolic Architecture Compound AI Solution