Outcomes
improved productivity for payer contracting team
Time to answer leadership contract questions down from hours or days
Near-zero errors on contract data outputs
Summary
With Turquoise, Loma Linda University Health moved their contract process off paper and out of spreadsheets and into a single, AI-searchable system. Questions that once took hours or days to answer for leadership now take minutes. The efficiency gains were real: the payer contracting team saved roughly 1,200 hours a month, a 10% improvement in efficiency, by getting instant visibility into payer language, reciprocity clauses, and policy changes without manually combing through PDFs. That freed the team to spend less time hunting for answers and more time on strategic negotiations and cross-departmental business development.
The problem
Loma Linda University Health (LLU) is a faith-based academic medical center in Southern California operating at six separate locations, over a dozen service lines and specialty departments, each tied to a complex web of payer contracts. For Don Clapp, Director of Payer Contracting, alongside the team of payer contract managers, managing that portfolio meant navigating a patchwork of paper files, spreadsheets, and eventually a cloud-based document repository that functioned more like a filing cabinet than a contract management system.
When leadership needed to know termination notification requirements across their book of contracts, or whether a particular payer's reciprocity language gave third parties access to LLU's rates, the only option was manual review: opening each PDF, searching each section, and compiling answers by hand. Depending on the scope of the question, that process could take hours to days.
"The biggest risk was having leadership need information and not being able to get it to them in a timely manner. It sometimes delayed being able to get the information they needed to make decisions." —Don Clapp, Director of Payer Contracting, Loma Linda University Health
When COVID forced the entire team to work remotely, the fragility of that system became undeniable. Paper files sat miles away from the contractors who needed them. Even after transitioning to a cloud-based system, the workflow remained essentially manual. Queries couldn't be run across contracts, and any data was only as current as the last time someone had uploaded a revised document.
Over the years, the team had looked at bringing on other contract management solutions over, but found that most were built for legal departments and weren’t tailored to healthcare, or they served as electronic storage with no ability to actually understand and leverage the information inside of their contacts. LLU needed a system built for the specific language and workflows of healthcare contracting.
"Turquoise speaks our language. They understand healthcare where a lot of vendors really didn't," said Clapp.
Loma Linda University Health moves from manual contract management to real-time contract intelligence
LLU was initially introduced to Turquoise when searching for a partner who could help them publish compliant machine-readable files (MRFs). After a successful engagement, Contracts quickly became the next highest priority, and shortly thereafter, the team migrated its full contract portfolio into the platform and started to build new workflows around its AI-powered capabilities.
The difference showed up immediately in how the team handles everyday questions. Before, a request like "What is the average number of days' notice required to terminate our contracts?" required manually checking each contract's relevant section and compiling results. Now that query runs in real time through AskTQ, Turquoise's AI assistant, and returns an answer in seconds.
"Before, it was hours or days depending on the magnitude. Now it's a matter of minutes. I can respond within an hour to most questions we get," said Clapp.
The team uses AskTQ across three primary use cases:
- Clause retrieval and policy comparison: Contractors query specific contract language: billing timelines, termination notice requirements, observation rates, and more, across the entire portfolio at once rather than reviewing each payer's contract separately.
- Silent change detection: When payers send updated amendments or policy changes as PDFs without marking what changed, the team uses Contracts to compare documents and surface edits. This is particularly critical given LLU has just 30 days to object to a policy change before losing the right to terminate the contract.
- Negotiation prep: As LLU moves into contract renewals, contractors use the platform to review existing language across their book of business, compare rate data from Turquoise's broader dataset, and identify where contract terms diverge from community standards.
Reciprocity clauses offered one clear example of the platform's value. When LLU wanted to prevent terminated payers from accessing their contracted rates through arrangements embedded in other payers' contracts, the team needed to quickly identify which contracts contained reciprocity language and what those clauses allowed. AskTQ surfaced the relevant clauses across the full portfolio in minutes.
Kevin Lang, Vice President of Payer Contracting, described how the platform also changed team accountability: "When you can simplify the process so that each contractor is responsible for their contracts, it creates accountability and reliability in a way that wasn't possible before."
"The AI functionality, AskTQ, is above and beyond what I had originally hoped for. Our contractors use it to compare contracts, surface clause language in real time, query billing timeframes across every payer. It's changed how we work." —Clapp
The outcome
Two years in, the impact on LLU's contracting team is transformative. A team of six now saves roughly 1200 hours a month. Contract renewals are moving faster. The team has shifted its focus from data retrieval to strategic work, including analyzing financial performance, supporting business development for clinical departments, and preparing more rigorous negotiation positions.
"It's allowed us to be more strategic in what we do. For some of the contracts, we can now lump lighter contracts together and free up time for contractors to work on projects like helping the business office in collections or supporting departments on business development," said Clapp.
Leadership now receives answers to contract questions within an hour rather than waiting a day or more. Policy change notices from payers, once requiring time-consuming manual comparison against prior versions, are now reviewed systematically through the platform, reducing the risk of missing objection windows.
For Clapp and Lang, the value of the last two years goes beyond the platform itself. "I never heard anybody discouraging the process,' said Lang. 'It was more that everybody was excited because they could see the end and what it was going to do. Everything's going to be better.' Clapp put it more simply: 'You can't say this with many vendors, but this has definitely been a pleasure."
