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Murphi AI

AI for Managed Care Functions — Murphi.ai
Who We Serve — Health Systems & Hospitals › AI for Managed Care Functions

AI-Powered Payer Contract Intelligence for Health Systems

Murphi.ai's Contract Analyzer uses the PADU+ methodology to dissect every payer contract clause, compare it against your own manuals and policies, surface contract evidence at a click, and help your managed care team build sharper negotiation leverage.

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SS
Stuart Smith · Board Advisor, Murphi.ai VP Finance, Duke University Health System — guiding Murphi.ai's managed care and health system strategy.
Board Advisory Announcement · 2026
Who It's For

Managed Care & Payer Contracting Teams

Health Systems & IDNs VP / Director of Managed Care Payer Contracting Teams Revenue Integrity CFO / Finance Revenue Cycle Leadership Compliance Officers Coding & Billing Consultants

Managed care contracts govern every dollar a health system earns from commercial payers — yet most contracting teams still read them in PDF, compare terms manually, and build negotiation prep in spreadsheets. Murphi.ai's Payer Contract Analyzer replaces that manual process with AI-powered clause analysis, evidence-linked findings, and structured negotiation notes — all in one secure workspace.

HIPAA Compliant
SOC 2 Certified
ISO 27001
BAA Signed
Contract Data Encrypted at Rest
24/7 Support · Submit a Ticket →
Why It Matters

The Managed Care Problem Is Hiding in Your Contracts

Health systems leave significant revenue on the table every year because contract terms are misapplied, misunderstood, or never negotiated in the first place.

10–20%
Revenue increase potential identified by Contract Analyzer
80%+
Reduction in manual contract research time
Hours → Minutes
Time to find and verify a specific contract clause
100%
Clause findings backed by evidence — no hallucinations
The PADU+ Methodology

How Murphi.ai Reads Every Contract Clause

Every clause in every payer contract is scored using the PADU+ framework — a four-tier assessment model developed specifically for managed care contract analysis. Each clause is rated Preferred, Acceptable, Discouraged, or Unacceptable, linked to the exact source text, and compared against your internal manuals and payer policies.

PADU+ gives your contracting team a clear, consistent language for evaluating contract quality. A Preferred clause is the gold standard your negotiators should be pushing toward. An Acceptable clause meets baseline requirements. A Discouraged clause introduces risk or unfavorable terms worth challenging. An Unacceptable clause is a hard stop — it must be removed or renegotiated before execution. Every rating is traceable to the contract page and line.

P
Preferred — Clause is the gold standard for your organization
Contract language is optimal — it fully aligns with your operational standards, protects your reimbursement, and reflects best-practice contract terms. Your negotiators should use Preferred clauses as the benchmark to anchor future renewals.
e.g. "Payment within 30 days of clean electronic claim receipt, with interest accruing on delayed payments" — Preferred: tight timeline plus interest provision.
A
Acceptable — Clause meets baseline requirements
The term is not optimal but meets the minimum threshold your organization can operate within. No immediate action needed, but these clauses should be tracked as targets for improvement at the next renewal cycle.
e.g. "Payment within 45 days of clean claim receipt" — Acceptable: within state prompt-pay law, but not as favorable as a 30-day term.
D
Discouraged — Clause introduces financial or operational risk
The term is unfavorable and creates meaningful exposure — reimbursement risk, operational burden, or compliance complexity. Your managed care team should push back on Discouraged clauses before signing and prioritize removing them at renewal.
e.g. "Payer reserves the right to retrospective audit up to 36 months" — Discouraged: extends beyond industry norm of 12–24 months; creates prolonged financial uncertainty.
U
Unacceptable — Clause must be removed or renegotiated
The term is a hard stop. It violates your operational policies, creates unacceptable financial risk, conflicts with a regulatory requirement, or gives the payer unrestricted unilateral power. Do not execute a contract with an Unacceptable clause unresolved.
e.g. "Payer may amend reimbursement rates at any time without prior notice to Provider" — Unacceptable: no rate stability, no notice, no recourse.
+
PLUS Extensions — Context tags beyond the four-tier score
Each PADU rating carries additional context tags: Negotiation Leverage, Reimbursement Risk, Rate Opportunity, Compliance Gap, Manual Conflict — so your team knows not just how a clause scores, but what to do with it next.
e.g. A Discouraged audit clause tagged "Negotiation Leverage" signals it's a strong trade in renewal — offer to accept 24 months in exchange for a rate improvement.
Live Product Demo

The Payer Contract Analyzer — In Action

Upload a contract, select a finding, and see the clause evidence and comparison instantly. Add negotiation notes without leaving the screen.

Murphi.ai — Payer Contract Analyzer
PADU+ Active
Contracts
Aetna Commercial 2026
147 clauses · 23 findings
BCBS Amendment A
89 clauses · 11 findings
UHC Facility 2025
212 clauses · 31 findings
Reference Documents
Operations Manual v4.2
Uploaded · 2026-01-15
Aetna Provider Manual
Payer · 2026 Edition
PADU+ Summary
Preferred 8
Acceptable 7
Discouraged 5
Unacceptable 3
Evidence Preview
Select a finding to view the contract clause evidence and comparison.
How It Works

From Contract PDF to Negotiation-Ready in Minutes

No manual reading, no spreadsheet comparison, no version confusion. Murphi.ai does the analysis — your team makes the decisions.

1
Upload Contract PDF
Drag in any payer contract — main agreement, exhibit, or amendment. All pages processed.
2
Upload Reference Documents
Add your operations manual, payer provider manual, or fee schedule. Murphi uses these for comparison.
3
PADU+ Analysis Runs
AI rates every clause — Preferred, Acceptable, Discouraged, or Unacceptable — with evidence and reasoning linked to the source text.
4
Review Findings & Evidence
Click any finding to see the exact contract language, the comparison source, and the AI's reasoning.
5
Add Negotiation Notes
Annotate Discouraged and Unacceptable clauses directly in the platform — building your negotiation brief as you review.
Module Features

What the Contract Analyzer Does Today

Every feature listed here is live. We are honest about what exists — and what is on the roadmap.

● Live
PADU+ Clause Classification
Every contract clause is rated Preferred, Acceptable, Discouraged, or Unacceptable using the PADU+ methodology — with AI reasoning and evidence for each finding.
  • Processes full contract PDFs including exhibits and amendments
  • Rates every clause, not just flagged terms
  • Displays P / A / D / U status badge alongside each finding
  • Reasoning shown inline — traceable to the source clause
● Live
Evidence Preview
Every finding links to the exact contract clause that generated it — highlighted in context. Your team verifies AI findings against source text in one click.
  • Exact contract language shown for each PADU+ finding
  • Relevant sentence or phrase highlighted automatically
  • No manual searching of the PDF required
  • Full surrounding paragraph shown for context
● Live
Manual & Policy Comparison
Upload your operations manual and the payer's provider manual. Murphi compares every contract clause against both — surfacing conflicts, gaps, and discrepancies.
  • Supports your operations manual upload (PDF or Word)
  • Ingests payer provider manuals for side-by-side comparison
  • Conflicts between contract and manual rated Discouraged or Unacceptable
  • Reference from the manual shown alongside contract evidence
● Live
Negotiation Notes
Add structured negotiation notes to any PADU+ finding — directly in the platform. Build your complete payer negotiation brief as you review, clause by clause.
  • Inline annotation on any contract clause or finding
  • Notes attributed to the team member who added them
  • Filter to view only clauses with negotiation notes
  • Export notes for payer negotiation prep and meetings
● Live
Multi-Contract Workspace
Manage your full payer contract library in one workspace — Aetna, BCBS, UHC, Cigna, and any other payer. Switch between contracts instantly, with all annotations preserved.
  • Unlimited contract uploads per workspace
  • Separate PADU+ analysis per contract and amendment
  • Switch between contracts with a single click
  • All notes and annotations maintained per contract
Coming Soon
Reimbursement Rate Benchmarking
Compare your contracted rates against Medicare benchmark and market rates — identifying where your contracts are underpaying and quantifying the revenue opportunity.
  • Medicare rate comparison per CPT code
  • Market rate percentile positioning
  • Revenue opportunity quantification by payer
  • Negotiation target rate generation
Use Cases

Who Uses It and Why

The Contract Analyzer is built for every team involved in payer relationships — from contracting through compliance.

VP / Director of Managed Care
Prepare for Payer Renewals in Days, Not Weeks
Upload the expiring contract, review every Unacceptable and Discouraged clause, add negotiation notes clause by clause, and walk into the renewal meeting with a complete, prioritized brief — built by AI, owned by your team.
PADU+ AnalysisNegotiation NotesEvidence Preview
Revenue Integrity / Revenue Cycle
Identify Contract Terms That Drive Underpayments
Cross-reference Discouraged and Unacceptable contract clauses with your operations manual to identify where payer payment behavior diverges from contract terms — building the evidence base for recoupment and appeals.
Manual ComparisonDiscouraged FindingsPolicy Reference
Compliance Officer / Legal Counsel
Audit Contract Language Against Regulatory Requirements
Upload federal and state regulatory guidelines alongside the payer contract. Murphi flags clauses that conflict with prompt payment laws, network adequacy requirements, or CMS rules — with source evidence for every finding.
Regulatory ComparisonEvidence PreviewDispute Documentation
CFO / Finance Leadership
Quantify the Revenue at Risk in Your Contract Portfolio
Get a PADU+ summary across all payer contracts — how many clauses are Unacceptable, Discouraged, Acceptable, or Preferred — and prioritize which payer relationship needs the most urgent attention.
Portfolio ViewRisk SummaryMulti-Contract
Coding & Billing Consultants
Validate Contract Terms Against Billing Operations
Upload client contracts alongside your billing policies. Identify clauses that create billing compliance risk — timely filing windows, clean claim definitions, modifier policies — and deliver a structured findings report to the client.
Client ContractsBilling PolicyFindings Export
Managed Care Contracting Team
Track Amendments and Compare Contract Versions
Upload both the base contract and a proposed amendment. Murphi analyzes each document and lets your team compare PADU+ findings between versions — instantly surfacing what changed and what it means.
Amendment UploadVersion ComparisonChange Summary
What's Live · What's Next

Managed Care AI — Honest Roadmap

We are transparent about what is live today and what is on the roadmap. The current module is the foundation for everything that follows.

Payer Contract Analyzer
PADU+ classification, evidence preview, manual comparison, and negotiation notes. Live now.
2
Rate Benchmarking
Compare contracted rates against Medicare and market benchmarks. Quantify revenue opportunity per payer. Coming soon.
3
Underpayment Detection
Connect contract terms to actual claims payments — surfacing systematic underpayments and quantifying recovery. Roadmap.
4
Payer Policy Monitoring
Continuous monitoring of payer policy updates — alerting when a policy change affects your contracted terms. Roadmap.
Security & Governance

Your Contract Data Is Safe

Payer contracts are among the most sensitive financial documents a health system holds. Murphi.ai treats them accordingly.

Encryption at Rest & in Transit
All contract documents and analysis data encrypted with AES-256 at rest and TLS 1.3 in transit
Role-Based Access Control
Contracts visible only to authorized team members — configurable by contract, payer, or user role
Audit Trail
Every view, annotation, and export logged with user and timestamp — full activity history per contract
SOC 2 Certified
Independent third-party security certification — audit completed and maintained annually
ISO 27001
Information security management aligned to international standards
BAA Signed
Business Associate Agreements executed with every health system organization
No Training on Your Data
Your contract documents are never used to train AI models — your proprietary terms stay private
AWS & GCP Only
HIPAA-eligible cloud infrastructure — no other cloud providers used for data processing
Murphi.ai CTA Banner — Hardened
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