Contract Term Library

What it is

Contract Term Library is the reference companion to PayerPolicy Watch's change feed: where PayerPolicy Watch tells you what just changed, Contract Term Library tells you what the rule currently is. For every commercial payer and every state, the library captures timely filing limits, prompt-pay statutory deadlines, appeal turnaround requirements, prior-authorization decision windows, fee schedule update cadence, and the administrative requirements that govern claims submission and reconsideration.

Each entry is sourced to the carrier provider manual or the state statute that establishes it, with the publication or enactment date. When the rule changes, the prior version is preserved in the history view — a litigator can pull the term that was in force on the date of service, not just the current version.

Adjacent extension of PayerPolicy Watch, same pipeline. Sold under named institutional license to RCM operations and provider-side counsel.

Distribution and join path

Scope: Nationwide; TN prompt-pay and provider-manual slice; Nashville buyer support

Entity graph join: `payer_id`, `policy_id`, state code, `npi`/provider type, contract clause taxonomy.

Primary data sources

• Carrier provider manuals — Administrative requirements, timely filing, appeal deadlines
• State prompt-pay statutes — Statutory payment-timing requirements by state
• CMS Conditions of Participation — Federal baseline requirements
• State insurance code — State-level administrative requirements on health insurers

Buyers

• Hospital and physician-group revenue cycle leadership
• Provider-side healthcare attorneys
• Managed-care contracting teams
• RCM software companies licensing reference data

Methodology

Every term is sourced to the provider manual or statute that establishes it; prior versions are preserved with effective dates so a litigator can pull the term that was in force on any past date.

Read the methodology page