The infrastructure connecting your contracts to payment outcomes

The infrastructure connecting your contracts to payment outcomes

The infrastructure connecting your contracts to payment outcomes

Know what you're owed, where payments fall short, and why

Know what you're owed, where payments fall short, and why

For Revenue Cycle, Managed Care, And Finance

You know what you were paid.
But is it what you were owed?

You know what you were paid.

But is it what you were owed?

You know what you were paid.

But is it what you were owed?

Most organizations can tell you what they were paid. Very few can tell you what they should have been paid, or explain why the difference exists.

Kubera is built for the health systems, hospital groups, and specialty platforms where the number of contracts, payors, and service lines makes that variance structurally impossible to manage without the right infrastructure.

Most organizations can tell you what they were paid. Very few can tell you what they should have been paid, or explain why the difference exists.

Kubera is built for the health systems, hospital groups, and specialty platforms where the number of contracts, payors, and service lines makes that variance structurally impossible to manage without the right infrastructure.

Rate for DRG 470?
$24,500.00
Per claim, UHC Commercial
UHC_Commercial.pdf · §4.2
Where are we losing money?
−$284,720
Aetna · 47 claims this quarter
Underpayment_Q4.csv
Model +5% on Outpatient renewal
+$1.24M / yr
12,847 claims · Aetna highest leverage
Renewal_scenarios.csv
What changed in UHC's policy?
3 changes effective Jan 15 — prior auth required for MRI, telehealth carveout removed, +2% inflation adjuster applied.
UHC_Policy_Update.pdf
Stop_Loss_Carveout.pdf
UHC_Amendment.pdf
Fee_Schedule.xlsx
Aetna_Q4_2025.pdf
4
Rate for DRG 470?
$24,500.00
Per claim, UHC Commercial
UHC_Commercial.pdf · §4.2
Where are we losing money?
−$284,720
Aetna · 47 claims this quarter
Underpayment_Q4.csv
Model +5% on Outpatient renewal
+$1.24M / yr
12,847 claims · Aetna highest leverage
Renewal_scenarios.csv
What changed in UHC's policy?
3 changes effective Jan 15 — prior auth required for MRI, telehealth carveout removed, +2% inflation adjuster applied.
UHC_Policy_Update.pdf
Stop_Loss_Carveout.pdf
UHC_Amendment.pdf
Fee_Schedule.xlsx
Aetna_Q4_2025.pdf
4

Challenges

The payment problems most

providers don't know they have

Most organizations are leaving

significant revenue behind

Payor contracts are dense, unstructured, and disconnected from your data

Millions lost to undetected underpayments

Billions lost to contract complexity

and payment inaccuracy

Healthcare organizations on both sides of the payor-provider relationship lose billions annually to contract complexity - because no system connects what was agreed to what was actually paid.

Healthcare organizations on both sides of the payor-provider relationship lose billions annually to contract complexity - because no system connects what was agreed to what was actually paid.

Healthcare organizations on both sides of the payor-provider relationship lose billions annually to contract complexity - because no system connects what was agreed to what was actually paid.

Every renewal starts with

an information deficit

Without clear benchmarks and contract performance data, you enter renewals armed only with spreadsheets giving payors the upper hand.

Without contract performance history and payment variance data, both sides enter renewals without a clear picture of how agreements are actually performing - and decisions get made on incomplete information.

Every renewal starts with

an information deficit

Without clear benchmarks and contract performance data, you enter renewals armed only with spreadsheets giving payors the upper hand.

Every renewal starts with

an information deficit

Without clear benchmarks and contract performance data, you enter renewals armed only with spreadsheets giving payors the upper hand.

Disconnected data leaves contract performance invisible

Disconnected data leaves contract performance invisible

Contract files, claims data, and payment reports live in separate systems across separate teams, meaning no team has the full picture of what payor contracts are actually delivering.

Contract files, claims data, and payment reports live in separate systems across separate teams, meaning no team has the full picture of what payor contracts are actually delivering.

Disconnected data leaves contract performance invisible

Contract files, claims data, and payment reports live in separate systems across separate teams, meaning no team has the full picture of what payor contracts are actually delivering.

In Their Words

The system they'd been looking for

The system they'd been looking for

The system they'd been looking for

We’ve wanted to assess performance of our programs and contracts but don’t have systems to help us. Kubera is the first we’ve seen that can pull in many data sources, serve as a source of truth, and help our teams uncover revenue opportunities.

VP of Managed Care · Southeast Regional Health System

“ We needed a hub for all our contracts and fee schedules — a place where we could see if payors were actually staying within their contracted guidelines. That used to be impossible without a tool like this.

VP of Managed Care · Southeast Regional Health System

“ We needed a hub for all our contracts and fee schedules — a place where we could see if payors were actually staying within their contracted guidelines. That used to be impossible without a tool like this.

VP of Managed Care · Southeast Regional Health System

Provider Use Cases

One system that connects

what was agreed to what was paid

End-to-end contract & payment intelligence

End-to-end contract & payment intelligence

Revenue Recovery

Underpayment Detection and Recovery

Underpayment Detection and Recovery

Underpayment Detection

and Recovery

Underpayment Detection

and Recovery

Continuously compare every payment against your contract terms. High-value recovery opportunities surface automatically - classified and prioritized for impact.

Claim PCN000453587
Inpatient · DRG 470 · UHC Commercial
Detected
High value
Case opened
Expected payment$253,752.39
Total paid$235,338.97
Variance$0.00

Negotiation Intelligence

Contract Renewal Preparation

Contract Renewal Preparation

Prioritize contracts to re-negotiate by rates and contract term performance. Model proposed rate changes against your actual claims volume before signing.

Inpatient
4,200 claims · 32.7%
−$94,200
−2.8% applied rate
Outpatient
6,100 claims · 47.5%
−$71,800
−3.5% applied rate
Emergency Dept
2,547 claims · 19.8%
−$58,612
−4.1% applied rate
Modeled total impact
12,847 claims · 3.2% blended cut
−$224,612

Negotiation Intelligence

Contract Renewal Preparation

Prioritize contracts to re-negotiate by rates and contract term performance.

Model proposed rate changes against your actual claims volume before signing.

Inpatient
4,200 claims · 32.7%
−$94,200
−2.8% applied rate
Outpatient
6,100 claims · 47.5%
−$71,800
−3.5% applied rate
Emergency Dept
2,547 claims · 19.8%
−$58,612
−4.1% applied rate
Modeled total impact
12,847 claims · 3.2% blended cut
−$224,612

Negotiation Intelligence

Contract Renewal Preparation

Prioritize contracts to re-negotiate by rates and contract term performance. Model proposed rate changes against your actual claims volume before signing.

Inpatient
4,200 claims · 32.7%
−$94,200
−2.8% applied rate
Outpatient
6,100 claims · 47.5%
−$71,800
−3.5% applied rate
Emergency Dept
2,547 claims · 19.8%
−$58,612
−4.1% applied rate
Modeled total impact
12,847 claims · 3.2% blended cut
−$224,612

Operational Alignment

Cross-Team Contract Visibility

Cross-Team Contract Visibility

Revenue Cycle, Finance, and Managed Care unified on one source of contract and payment data - no reconciliation gaps, no version conflicts.

Contract access3 teams aligned
  • RC
    Revenue CycleEditor · Flags variances
    SyncingSynced
  • F
    FinanceReviewer · Approves recoveries
    SyncingSynced
  • MC
    Managed CareOwner · Negotiates renewal
    SyncingSynced

Operational Alignment

Cross-Team Contract Visibility

Revenue Cycle, Finance, and Managed Care unified on one source of contract and payment data - no reconciliation gaps, no version conflicts.

Contract access3 teams aligned
  • RC
    Revenue CycleEditor · Flags variances
    SyncingSynced
  • F
    FinanceReviewer · Approves recoveries
    SyncingSynced
  • MC
    Managed CareOwner · Negotiates renewal
    SyncingSynced

Contract Intelligence

Compliance

Contract Ingestion and Modeling

Contract Ingestion and Modeling

Every contract, amendment, fee schedule, and provider manual across your entire portfolio of actual agreements structured into queryable logic.

Coventry Health · Workers' Comp
Effective 09/01/2024 — 09/01/2026 · Section 4: Rates
CodeDescriptionRate
MS-DRG 871Septicemia / Severe Sepsis w/ MCC100% CMS Medicare
MS-DRG 853Infectious & Parasitic Diseases100% CMS Medicare
HCPCS 99284Emergency Dept Visit Lvl 440% Billed Charges
HCPCS 70450CT Head w/o Contrast40% Billed Charges
942 codes · structured
CodeClaimsRate MethodRevenue
871MS-DRG153100% CMS Medicare$2,662,404.97
853MS-DRG16100% CMS Medicare$702,064.10
99284HCPCS92540% Billed Charges$1,042,196.60
70450HCPCS25740% Billed Charges$297,288.74

Payment Accuracy

Always On Policy Change Detection

When payors update policy notices, Kubera surfaces what changed and what it means for your reimbursement - before it shows up as a denial.

Coventry Health · Workers' Comp
Effective 09/01/2024 — 09/01/2026 · Section 4: Rates
CodeDescriptionRate
MS-DRG 871Septicemia / Severe Sepsis w/ MCC100% CMS Medicare
MS-DRG 853Infectious & Parasitic Diseases100% CMS Medicare
HCPCS 99284Emergency Dept Visit Lvl 440% Billed Charges
HCPCS 70450CT Head w/o Contrast40% Billed Charges
942 codes · structured
CodeClaimsRate MethodRevenue
871MS-DRG153100% CMS Medicare$2,662,404.97
853MS-DRG16100% CMS Medicare$702,064.10
99284HCPCS92540% Billed Charges$1,042,196.60
70450HCPCS25740% Billed Charges$297,288.74

Contract Intelligence

Contract Ingestion and Modeling

Every contract, amendment, fee schedule, and provider manual across your entire portfolio of actual agreements structured into queryable logic.

Coventry Health · Workers' Comp
Effective 09/01/2024 — 09/01/2026 · Section 4: Rates
CodeDescriptionRate
MS-DRG 871Septicemia / Severe Sepsis w/ MCC100% CMS Medicare
MS-DRG 853Infectious & Parasitic Diseases100% CMS Medicare
HCPCS 99284Emergency Dept Visit Lvl 440% Billed Charges
HCPCS 70450CT Head w/o Contrast40% Billed Charges
942 codes · structured
CodeClaimsRate MethodRevenue
871MS-DRG153100% CMS Medicare$2,662,404.97
853MS-DRG16100% CMS Medicare$702,064.10
99284HCPCS92540% Billed Charges$1,042,196.60
70450HCPCS25740% Billed Charges$297,288.74

Compliance

Price Transparency Reporting

CMS price transparency compliance becomes a single automated output - not a multi-week manual project.

Coventry Health · Workers' Comp
Effective 09/01/2024 — 09/01/2026 · Section 4: Rates
CodeDescriptionRate
MS-DRG 871Septicemia / Severe Sepsis w/ MCC100% CMS Medicare
MS-DRG 853Infectious & Parasitic Diseases100% CMS Medicare
HCPCS 99284Emergency Dept Visit Lvl 440% Billed Charges
HCPCS 70450CT Head w/o Contrast40% Billed Charges
942 codes · structured
CodeClaimsRate MethodRevenue
871MS-DRG153100% CMS Medicare$2,662,404.97
853MS-DRG16100% CMS Medicare$702,064.10
99284HCPCS92540% Billed Charges$1,042,196.60
70450HCPCS25740% Billed Charges$297,288.74

Payment Accuracy

Always On Policy Change Detection

Always On Policy Change Detection

When payors update policy notices, Kubera surfaces what changed and what it means for your reimbursement - before it shows up as a denial.

Policy update detected
UHC Commercial · Bulletin 2026-01 · 14m ago
Timely Filing Window
9060days
Effective Feb 1, 2026 · 18 days from now
240 active claims · $0 at risk

Compliance

Contract Ingestion and Modeling

Every contract, amendment, fee schedule, and provider manual across your entire portfolio of actual agreements structured into queryable logic.

Policy update detected
UHC Commercial · Bulletin 2026-01 · 14m ago
Timely Filing Window
9060days
Effective Feb 1, 2026 · 18 days from now
240 active claims · $0 at risk

Payment Accuracy

Always On Policy Change Detection

When payors update policy notices, Kubera surfaces what changed and what it means for your reimbursement - before it shows up as a denial.

Policy update detected
UHC Commercial · Bulletin 2026-01 · 14m ago
Timely Filing Window
9060days
Effective Feb 1, 2026 · 18 days from now
240 active claims · $0 at risk

Compliance

Contract Intelligence

Price Transparency Reporting

Price Transparency Reporting

CMS price transparency compliance becomes a single automated output - not a multi-week manual project.

Output
machine_readable_q4_2025.json · 2.3 MB
All checks passed
Kubera Compliance Engine
Engine has assembled the Q4 submission:
  • All providers pricing extracted
  • Standard charges validated
  • Claims utilization data added
  • CMS schema validated
  • Ready · 18 days before Oct 1 deadline

Contract Intelligence

Price Transparency Reporting

CMS price transparency compliance becomes a single automated output - not a multi-week manual project.

Output
machine_readable_q4_2025.json · 2.3 MB
All checks passed
Kubera Compliance Engine
Engine has assembled the Q4 submission:
  • All providers pricing extracted
  • Standard charges validated
  • Claims utilization data added
  • CMS schema validated
  • Ready · 18 days before Oct 1 deadline

Compliance

Price Transparency Reporting

CMS price transparency compliance becomes a single automated output - not a multi-week manual project.

Output
machine_readable_q4_2025.json · 2.3 MB
All checks passed
Kubera Compliance Engine
Engine has assembled the Q4 submission:
  • All providers pricing extracted
  • Standard charges validated
  • Claims utilization data added
  • CMS schema validated
  • Ready · 18 days before Oct 1 deadline

Contract Intelligence

Contract Ingestion and Modeling

Every contract, amendment, fee schedule, and provider manual across your entire portfolio of actual agreements structured into queryable logic.

Output
machine_readable_q4_2025.json · 2.3 MB
All checks passed
Kubera Compliance Engine
Engine has assembled the Q4 submission:
  • All providers pricing extracted
  • Standard charges validated
  • Claims utilization data added
  • CMS schema validated
  • Ready · 18 days before Oct 1 deadline

Provider Impact

Payment accuracy. Less reconciliation.

Full contract visibility.

The numbers that matter to your CFO

Measurable outcomes from contract and payment intelligence

$1M+ in improvements year one

$1M+

in improvements year one

$1M+ in improvements year one

Kubera customers identify an average of $1M+ in

contract improvements and payment inaccuracies

in year one - without adding headcount or changing

how claims are submitted.

Kubera customers identify an average of $1M+ in contract improvements and payment inaccuracies in year one - without adding headcount or changing how claims are submitted.

Kubera customers identify an average of $1M+

in contract improvements and payment inaccuracies

in year one - without adding headcount or changing

how claims are submitted.

Kubera customers identify an average of $1M+ in contract improvements and payment inaccuracies in year one - without adding headcount or changing how claims are submitted.

Kubera customers identify an average of $1M+

in contract improvements and payment inaccuracies in year one - without adding headcount or changing how claims are submitted.

40+ hrs reclaimed/week

10+ hrs

reclaimed/week

10+ hrs reclaimed/week

Over 40 hours reclaimed per organization every week. Contract, claims, and payment data unified within one system means

no reconciliation across platforms, no version conflicts,

and no reporting overhead.

Over 40 hours reclaimed per organization every week. Contract, claims, and payment data unified within one system means no reconciliation across platforms, no version conflicts,

and no reporting overhead.

Over 40 hours reclaimed per organization every week. Contract, claims, and payment data unified within

one system means no reconciliation across platforms,

no version conflicts, and no reporting overhead.

90 days to go live

90 days

to go live

90 days to go live

From contract ingestion to live payment monitoring

in 90 days. No heavy integration project, no dedicated

IT resource, not months of implementation before

value is visible.

From contract ingestion to live payment

monitoring in 90 days. No heavy integration project, no dedicated IT resource, not months of implementation before value is visible.

From contract ingestion to live payment monitoring in 90 days. No heavy integration project, no dedicated IT resource, not months of implementation before value

is visible.

From contract ingestion to live payment

monitoring in 90 days. No heavy integration project, no dedicated IT resource, not months

of implementation before value is visible.

“ Kubera transformed what was once two months of reporting work into two clicks.

We were wading through spreadsheets, manual data pulls, and reconciliation.

The time savings and speed to answers we’re experiencing now is groundbreaking.

“ Kubera transformed what was once two months of reporting work into two clicks. We were wading through spreadsheets, manual data pulls, and reconciliation. The time savings and speed to answers we’re experiencing now is groundbreaking.

National Hospital Network

National Hospital Network

National Hospital Network

“ Kubera transformed what was once two months of reporting work into two clicks.

We were wading through spreadsheets, manual data pulls, and reconciliation.

The time savings and speed to answers we’re experiencing now is groundbreaking.

National Hospital Network

Security

Scale with security

Kubera is fully secure & compliant

Scale with security

Kubera is fully secure & compliant

Scale with security

Kubera is fully secure & compliant

Enterprise-grade security

Enterprise-grade security

Your data stays yours always. Work with an AI platform that never trains on your PHI data. 

Your data stays yours always. Work with an AI platform that never trains on your PHI data. 

Your data stays yours always. Work with an AI platform that never trains on your PHI data. 

HIPAA

HIPAA

HIPAA

SOC2

SOC2

SOC2

  • ✓ BAA Support

    ✓ BAA Support

  • ✓ Modern & secure practices

    ✓ Modern & secure practices

  • ✓ Audit logs

    ✓ Audit logs

  • ✓ Encrypted end-to-end

    ✓ Encrypted end-to-end

  • ✓ No training on PHI

    ✓ No training on PHI

  • ✓ Modern & secure practices

    ✓ Modern & secure practices

Enterprise-grade security

Your data stays yours always. Work with an AI platform that never trains on your PHI data. 

HIPAA

SOC2

  • ✓ BAA Support

  • ✓ Modern & secure practices

  • ✓ Audit logs

  • ✓ Encrypted end-to-end

  • ✓ No training on PHI

  • ✓ Modern & secure practices

Stop writing off payments you

haven't investigated yet.

Stop writing off payments you

haven't investigated yet.

See which contracts are underperforming, which payments

don't match what was agreed, and where to act first.

See which contracts are underperforming, which payments

don't match what was agreed, and where to act first.

See which contracts are underperforming, which payments don't match what was agreed, and where to act first.

Copyright © Kubera Health

Address

33 Irving Place, Floor 5

New York, New York 10003

33 Irving Place

New York, New York 10003

33 Irving Place

New York, New York 10003

Copyright © Kubera Health

Address

33 Irving Place

New York, New York 10003