Trusted by innovators across the healthcare ecosystem
Leverage the only price transparency solution that unifies:
Payer & hospital price transparency
Benchmark each reimbursement in your market by comparing every payer-provider contracted rate.
Medicare fee schedules
Benchmark negotiated rates against Medicare fee schedules directly within your analysis.
All-payer claims & remits
Unlock deeper benchmarking with claim volumes & amounts. Identify ghost rates with real-world claims.
Carveouts and non-standard codes
Account for the nuances of carveouts and non-standard codes to capture the full picture of reimbursement.
Full historical data for trending
Track reimbursement trends across your entire market & access all historical contract rates instantly.
HCO
affiliations
Leverage healthcare organization ownership and affiliations to create accurate cohorts.
The next era of contract negotiations is here.
Understand every reimbursement
Benchmark & identify revenue opportunities with precision
Rate Explorer™
Power your pricing strategy & change the dynamic of payer negotiations with instant answers.
All payer-provider negotiated rates along with claims
Access every health plan with historical rates for trending
Self-service user experience with instant data access
Power your solutions instantly
Easily integrate price transparency data to build & scale faster
Payerset Data Lake™
Directly integrate the most complete price transparency data in your products & solutions.
Direct integration (API) or data share
Enriched NPI to TIN mapping
Full employer to health plan coverage
What makes the Payerset healthcare price transparency solution unique?
Price transparency essentials
The Payerset difference
All the details for every plan
We ingest every machine-readable file (MRF) published by payers for every plan as well as every compliant hospital. We do not take subsets of any dataset or cherry-pick plans.
Historical depth & refresh cadence
Full historical rate data for payer MRF, hospital MRF, & claims is accessible for trending and enhanced benchmarking. Our full dataset is refreshed quarterly.
360° view with claims & remits
Negotiated-rate data is linked to all-payer claims, surfacing what was actually paid, not just contracted. Easily analyze & see the complete view in a single location.
Data enrichment & QA
Our focus is making the data usable with enrichment such as mapping NPI to TIN, Hospital Care (HCO) affiliations, and standardizing various file and schema formats for easy analysis.
Self-service & direct integration
Our platform is designed for finance & managed care teams with a true, no-code self-service solution & our solution partners with enterprise-grade APIs & data sharing.
Industry alignment & partnerships
We collaborate closely with CMS & trusted ecosystem partners to both keep ahead & advise on standards & enforcement to make price transparency a reality.
Support for the community
Healthcare deserves a free & open market & that includes solution providers. We consolidate & document every MRF as well as publish a complete payer transparency scorecard here.
Don't take our word for it. See the Payerset difference in action.
Hear from our customers
Improve your bottom line
Trillions of rows of data mean nothing if they aren't curated to remove the noise from phantom rates, duplication, and irrelevant billing codes. We've done the work for you, so you can focus on optimizing your bottom line.
Rate disparity across major payers for Psychiatric Diagnostic Evaluations
Between the highest and lowest rates for a 45-min therapy session
Between the highest and lowest rates for Level 3 Est. Patient Office Visits
“Our payer negotiations were approaching and we were in the dark, but with Payerset we were able to see the range of negotiated rates at our payers for Behavioral Health organizations like us. Payerset empowered us to develop the right strategy and gave us the confidence to get competitive rates for our high utilization services.”
Holistic women’s mental health therapy, counseling, and medication management.
- Shama Rathi, MD, Co-Founder
hellolunajoy.com