Gain an understanding of what you can review, analyze, and track with the reports in HealthAnalytIQ's MedPrice Insight Module.
MedPrice Insight (MPI) is a comprehensive price transparency module. It uses data sourced from the Machine Readable Files (MRFs) provided publicly by insurers as a part of compliance with the Health Care PRICE Transparency Act 2.0. This module includes pricing information on medical services, including Allowed Amounts for all commercial payers in all 50 states, all physician specialties, all practice sizes, all procedure codes, all DRGs, all NDC drug codes, and more. This module allows for analysis along the following dimensions:
- Streamlined Contracting – MPI enables competitive market analysis that empowers users to identify reimbursement rates by geography, specialty, NPI or EIN; payment auditing that can flag payments that don't match your contracts, and the ability to benchmark against various commercial insurance rates. MPI enables intelligent, data driven managed care contracting process.
- Billions of Negotiated Rates – MPI contains information on all the in-network contracts between payers and providers, down to the NPI level. This can enable, among other things, the ability to compare claims payments at the line-item level against published contracted rates between plans and providers and the ability to highlight preferred providers such as telemedicine providers and onsite clinics to encourage or incentivize utilization within your network.
- In-network Analyses – MPI provides a foundation for building searchable payer and provider directories, creating new insurance plans in new geographical locations, understanding which providers are in-network with which payers and what their contracted rates are, and more.
- Pricing Transparency – The comprehensive pricing data sourced from payer machine readable files (MRFs) can display total provider cost, member out-of-pocket cost based on plan design, cost comparison across discrete physician specialties, facilities, geographies, and more.
- Reference Based Pricing (RBP) – As part of your cost-containment strategy, build a solid RBP program for some or all of your covered services by using benchmarks such as Medicare prices or a mix of criteria such as the median price of medical services in a given area or a given group of payers nationally or regionally.