Fully Outsourced Patient Cost Estimator Tool
100% CMS Compliant with 300 Shoppable Services
Bundled Cash Prices Calculated on Cost + Markup
CMS-Required Machine-Readable File of Contracted Rates for Every Service and Payer
HPS Copyrighted Format
Based off Client's Transactional Data and Payer Contracts
Benchmark service packages to identify differences in delivery of care
Compare prices at the encounter level and by line-item components
Analyze acuity levels across providers for the same service packages
Create a pre-service itemized statement to assist in developing a good faith estimate
Defensible Chargemaster Pricing
New Prices Modeled with Payer Contracts to Determine Impact on Net Patient Revenues
Deliverables in Excel Files and Online Dashboard
Establishes a Compliant, Current, and Accurate CDM
Ensuring Accurate Reimbursement
Adjusts Prices to Market and Fee Schedule Rates
Benchmark Outpatient CPT/HCPCS Prices to Market
Benchmark Inpatient MS-DRG Prices to Market
For Each Report, Select up to 14 Hospitals for Comparison
Data calculated on over $100 billion in hospital spending across 4,100+ facilities
Benchmark hospital costs, payments, and profitability against market competitors
Demonstrate high value to payers in contract negotiations
Identifies all underpayments based on contract terms
Proprietary payer performance analytics on 837/835
Calculates cost to collect on underpaid claims
Stratify outpatient providers by precise resource utilization differences
Accurately compare costs across providers, adjusting for utilization patterns
Assist with payer negotiations by highlighting resource utilization efficiencies
