Payer contract analytics
Payer contract analytics for surgery centers
Your payer contracts are promises with numbers in them. Perivanta checks every remit against those numbers — and builds the evidence file for the day you renegotiate.
Perivanta is in development with founding design partners — this page describes the capability we’re building together.
You signed the contract. Who’s checking the payer kept it?
Most ASCs have no systematic way to verify that payments match contracted rates. Remits arrive, get posted, and move on; a rate paid a few percent light, a carve-out applied wrong, or a lesser-of clause misfired simply becomes the number in the ledger. When discrepancies do surface, it’s often months after the procedures — past timely-filing windows, with the leverage gone.
The same blindness weakens negotiations. Independent centers walk into rate discussions without benchmarking, without their own case-mix economics, and across the table from payers who have all three. That asymmetry, repeated contract after contract, is a structural drag on independent ASC margins.
What Perivanta does with your remits and contracts
Perivanta turns contract terms into live rules, checks payment behavior against them continuously, and keeps the receipts.
Contract performance monitoring
Compares what each payer actually paid against contracted rates, remit by remit — so variance is a same-week flag, not a year-end surprise.
Underpayment detection
Flags patterns of short payment by payer, procedure, and contract clause, and packages the documentation recovery requires.
Denial trend analytics
Tracks denial rates and root causes by payer over time, separating your process problems from their behavior — and evidencing the difference.
Case-mix profitability
Shows margin by payer, procedure, and surgeon, so you know which volume builds your margin and which quietly erodes it.
Negotiation preparation
Assembles your performance history, payment behavior, and case economics into the evidence file you bring to the table.
Contract term modeling
Models what a proposed rate sheet would have meant against your actual historical case mix — before you sign it.
We arm the negotiation. You run it.
Perivanta isn’t a billing service, a clearinghouse, or a contracting middleman. Your payer relationships stay yours. The platform’s job is to end the information asymmetry — giving a physician-owned center the same continuous contract surveillance a national chain builds an analytics team for.
It works from data you already have: contracts, remittances, and claims history from your existing billing workflow. No new pipes to build before the analysis starts.
Common questions
- Is Perivanta a billing or RCM service?
- No. Perivanta analyzes payment behavior on top of your existing billing workflow — in-house or outsourced. It flags underpayments and denial patterns and prepares evidence; your team or billing partner acts on it.
- Will Perivanta negotiate with payers for us?
- No — and deliberately so. Payer relationships belong to your center. Perivanta prepares the analysis and evidence that make your negotiation stronger: your rates versus your economics, payment behavior over time, and what proposed terms would mean against your real case mix.
- What data does this require?
- Primarily your payer contracts and your remittance and claims history — data your billing process already produces. Perivanta is designed to read from the systems ASCs already run rather than requiring new data entry.
- How do ASCs usually discover underpayments today?
- Mostly by accident: a biller notices a rate looks off, an audit samples a quarter, or a consultant reviews contracts during a sale process. Systematic remit-level checking is rare outside large chains — which is exactly the gap continuous contract monitoring closes.
Explore the rest of the platform
Design partner program
Help build the system that decides what should happen next
We are selecting a small group of founding centers to shape the platform. Design partners get early access, direct input on the roadmap, and founding-partner terms.