THE PRODUCT ECOSYSTEM
Healthcare has never before had prices because the number moves with the payer, the plan, the provider, the code and the deductible already spent. Four years went into the protocol that holds all of it.
HEALTHCARE’S FIRST PRICING PROTOCOL
Nobody publishes what a payer pays a given provider for a given code. We model it from adjudicated claims at the NPI level, apply the patient’s live benefits, and check the result against the 835.
AUTO-LOAD FROM EHR
Pulls the practice’s schedule, providers, and codes nightly, so a price exists before the patient arrives.
INSURANCE VERIFICATION
Real-time eligibility through the clearinghouse, with automated benefit parsing when the response is ambiguous.
ALGORITHMIC BALANCING ENGINE
Predicts what this payer pays this provider for this code, modelled at the individual NPI rather than a market average.
ADJUDICATION RECONCILIATION
When the 835 comes back, the paid amount is reconciled against the predicted price. Accuracy is measured on every claim.
LIVE TODAY
Everyone else is still working from estimates.
The protocol is built, deployed, and reconciled against real claims every day.
