Contract & Benefit Optimization
Optimize Benefit & Contract Logic — Backed by Verified Outcomes
Audits explain what went wrong. Continuous verification prevents repeat errors. Optimization uses verified historical data to improve how benefit and contract logic is written going forward.
Optimization Opportunity
2
Rules to Fix
$420K
Potential Savings
The Problem
Rules Are Rarely Designed With Real Usage in Mind
Benefit and contract logic is often written:
before real-world usage is understood
under negotiation pressure
without visibility into edge cases
Over time, this leads to:
unused or ineffective clauses
overly broad restrictions
costly edge cases that only appear at scale
Optimization requires more than intuition — it requires verified evidence.
From Scattered Outcomes to Refined Rules
Original Rules
Scattered outcomes, hidden edge cases
Optimized Rules
Refined logic, predictable outcomes
The Visibility Problem
What Reports Show
What Optimization Needs
Optimization requires understanding rule behavior, not just outcomes.
The Gap
Why Optimization Is Hard Without Verified Data
Teams have experience, data, and tools. But optimization decisions still rely on incomplete information about how rules actually behave.
Manual reviews can't cover everything
Hundreds of rules, thousands of interactions — too much to examine by hand.
Analytics show trends, not logic
Spend forecasts predict outcomes but can't explain why specific rules fire.
Changes have unintended consequences
A threshold change that looks good on paper can trigger unexpected edge cases.
Optimization works best when you know exactly how rules behave — not just what outcomes look like.
How It Works
Verified Historical Data
Executable Logic Model
Optimization Recommendations
Evidence-based. Every recommendation is backed by verified data.
Our Approach
Optimization Built on Verified Logic
We don't predict what might work. We show you what would have worked — based on how your rules actually behaved.
Verify historical outcomes
Replay claims through your actual rules to establish ground truth.
Analyze rule usage patterns
Identify unused clauses, over-triggered rules, and costly edge cases.
Simulate alternative configurations
Test how changes would have altered outcomes — before deploying.
What We Optimize
The Hidden Costs Inside Your Logic
Most contract and benefit logic accumulates inefficiencies over time. Rules get added but rarely removed. Edge cases multiply. Thresholds drift from their original intent. These patterns are invisible in aggregate reporting — but they show up clearly when you analyze verified rule behavior.
Rules that fire too often
Broad logic that applies to cases it was never meant to cover.
Clauses that never trigger
Contract language that adds complexity without adding value.
Edge cases with outsized impact
Rare scenarios that account for disproportionate cost.
Interactions that create surprises
Rules that behave differently when they overlap or stack.
Rule Usage Analysis
85
Total rules
19
Need review
$340K
Opportunity
Deliverables
What You Get From Optimization
Every recommendation is backed by data that has already been verified against the rules.
Before / After Comparison
Current Logic
Rule triggers
12,450
Cost impact
$2.4M
Edge cases
847
Optimized Logic
Rule triggers
8,920
Cost impact
$1.9M
Edge cases
124
$500K saved with 85% fewer edge cases
When to Optimize
Optimization Fits Into Moments That Matter
The best time to optimize is when you're already making decisions about your contracts and benefits. We give you verified evidence to inform those decisions.
Contract Renewal
“Which terms should we renegotiate?”
Verified data shows which clauses drive cost vs. which never trigger.
Benefit Redesign
“How will this plan change affect outcomes?”
Simulate the new logic against historical claims before launch.
Post-Audit Action
“How do we prevent this from happening again?”
Identify the rule patterns that caused issues — and test fixes.
Strategic Planning
“Where are we leaving money on the table?”
Surface optimization opportunities ranked by verified impact.
Every recommendation is backed by verified historical outcomes — not projections or assumptions.