Superscript
Phreesia + Superscript

The pricing infrastructure behind the Phreesia check‑in.

Phreesia knows the patient's benefits. We model what the payer pays that provider for that code. Together those two terms produce a number a patient can pay before the visit, on coinsurance and deductible cases as well as copays.

PARTNER BRIEF
SEPTEMBER 2026
WHAT WE BUILD

We model the negotiated rate from the practice's own claims.

[1] INPUTS
INPUT 01Slot scheduling

Appointment type, duration, chair time.

INPUT 02Patient context

History, demographics, prior treatment.

INPUT 03Insurance context

Plan, benefits, contracted rates, accumulators.

INPUT 04Provider context

Specialty, fee schedule, practice patterns.

[2] PRICING ENGINE
SUPERSCRIPT Treatment prediction and pricing engine

Predicts the treatment a visit will produce, then prices it against the patient's real benefits and the provider's contracted rates, before the visit happens.

  1. 01Predict base treatment from visit context
  2. 02Model severity variants and likely add-ons
  3. 03Adjudicate each against plan benefits
  4. 04Split price: payer pays against patient owes
[3] OUTPUTS, EACH LINE PRICED
OUTPUT 01 / PRIMARY$1,240
Predicted base treatment

The most likely treatment for the booked slot, priced end to end.

OUTPUT 02+$180 / −$95
Severity changes

How the price moves if the case is more or less severe than predicted.

OUTPUT 03+$310
Likely additions

Adjacent procedures the visit is likely to include, each pre-priced.

ATTACHED TO EVERY PRICE Benefits explanation

Covered amount, deductible applied, patient responsibility, in plain language.

PRACTICES WE WORK WITH

Practices running Phreesia collect 65% to 80% of the patient cost share.

Running Superscript alongside Phreesia, patient collections reach 90%+.

The copay is priced and collected at check-in. Coinsurance and deductible cases still wait for a claim.

PARTNERSHIP CONCEPT

The same check-in, with a number on the coinsurance and deductible cases.

The patient flow stays exactly as it is. The cost card comes back with a number on it.

01Eligibility returns the plan. Deductible remaining, coinsurance percentage, accumulators.
02One call adds the rate. Payer × NPI × CPT, modeled from adjudicated claims.
03The patient sees a number, and pays it in the flow Phreesia already owns.
NOT A PHREESIA PRODUCT SCREEN
AN API CONFIGURABLE TO YOUR FRONT END

One call at check-in returns the patient's cost share.

PRICINGLIVE
POST/v1/pricing/estimates
{  "npi": "1447382910",  "payer_id": "AETNA",  "member_id": "W2214****",  "items": [{ "cpt": "73721" }]}
200 · RESPONSE
{  "modeled_rate":       156200,  "benefit": {    "deductible_remaining": 0,    "coinsurance":          0.20  },  "patient_responsibility": 31240,  "add_ons": [    { "cpt": "73721-26", "likelihood": 0.86 }  ]}
You send the context you already hold.

The provider, the payer, the member and the codes on the appointment. No change to how the patient moves through check-in.

Back comes the rate, the benefit and the balance.

Cents, not dollars. The modeled rate is what Aetna has been paying this NPI for CPT 73721, and the balance is that rate run through the patient's live accumulators.

Conditional procedures carry their likelihood.

0.86 is how often 73721-26 fires alongside 73721 at this provider, from claim co-occurrence rather than a national average, so the number holds when the visit changes.

REST and MCP, one endpoint at the front of it.

Eligibility, predictions, treatments, payer rates and batch pricing sit behind the same gateway if you want more than the one call.

ADDED PATIENT REVENUE AT EVERY VISIT

Collection at the point of service rose 42% across every eligible org.

PRICED BY THE EHR
$15.50

per visit. Covers 26% of the patient responsibility the claim eventually shows, on insured visits where the patient owed money.

PRICED BY SUPERSCRIPT
$41.36

per visit. Covers 73% of the patient responsibility on the same visits.

Collected at time of service, per visit$14.41 → $20.52+42%
Urgent care$18.52 → $42.00+127%
Pulmonology$12.95 → $21.04+62%
Pain management$14.51 → $21.49+48%
Orthopedics$20.21 → $27.35+35%
Allergy and immunology$18.94 → $20.48+8%

ALL ELIGIBLE ORGS, AUGUST 2026, AGAINST THE COMPARABLE WINDOW BEFORE GO-LIVE.

WHAT THAT MOVES FOR PHREESIA
+$1.4B

Patient payment volume, if capture on the same obligations moves from 70% to 90% against the $4.87B Phreesia processed in FY26. At the 2.49% implied by $121.5M of payment solutions revenue over that volume, roughly $35M on a $121.5M base.

AEOB

When advanced explanations of benefits become mandatory, be the only patient check-in with pricing already embedded rather than a compliance project to start.

Superscript 951 PROVIDERS LIVE · 1.48M TRANSACTIONS PRICED · 3,379 SERVICES NEW YORK · SEPTEMBER 2026 · SOC 2 · HIPAA · PCI