A New Price Transparency Solution

Trusted Price Intelligence

By combining one of the largest medical and pharmaceutical claims datasets in the U.S. with real-time price transparency insights from Payerset, we are able to deliver unparalleled clarity on negotiated rates, historical pricing trends, and payer coverage policies. 

PurpleLab’s Trusted Price Intelligence solution provides insights
into contracted rates across all payers, health plans, and care
delivery organizations, while providing real-world clinical insights
into the claims volume, service-line categorization, and provider
hierarchies.

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Solving Key Challenges

Trusted Price Intelligence solutions help Payers leverage data insights -beyond just MRFs - to better position themselves in negotiations and address outlier pricing that may be driving up costs.

Hospitals and Health systems can analyze pricing and claims data to benchmark their contracted rates and service line volumes to peer institutions and competitors. 

Optimization - Improve network performance by benchmarking rates and analyzing service line performance across markets

Contracting - Payers can compare actual reimbursement rates across provider to identify pricing trends and outliers. Providers can understand peer and competitor billing structures across equivalent procedures and services. This creates a full picture of actual reimbursement rates across payers.

Strategic Planning- Stay ahead of dynamic and competitive market conditions with up-to-date and actionable pricing data and utilization trends.

Rate Explorer

The Rate Explorer tool is the only self-service platform that provides real-time exploration of contracted rates across all payers, health plans, care delivery organizations, and services. Rate Explorer enhances traditional price transparency insights by offering access to:

Machine Readable Files - Quarterly-refreshed data from all payer-sourced MRFs and hospital MRF data.

Data & Insights - Providing real-time data discovery across all contract reimbursement rates, , actual claims volumetrics, clinical service lines, remit data and provider hierarchies

Easy-to-Navigate Exploration - Refining the data by reducing ghost rates, categorizing insurance plans, NPIs and billing codes, enriched with provider data for easy exploration.

Price Transparency Rate Explorer

Key Features

Comprehensive MRF Coverage

All Payer MRF data and hospital MRF data is refreshed quarterly and enhanced with provider data for easy exploration.

Enhanced Claims Data

Adding color to the standard MRFs, Trusted Price Intelligence integrates claims volumetrics data, clinical service line categorization, HCO and HCP hierarchies, standardized payer rates and remit data.

Rate Explorer

Easily navigate, understand, and benchmark healthcare pricing data paired with clinical insights. Surface actionable pricing insights to inform healthcare pricing and strategy to increase overall financial viability.

Real-time Discovery

Providing real-time data discovery across all contract reimbursement rates and discover business ready insights.