In network or out? Decide with the math.
Payers now publish what they pay. We turn those files into evidence for your IDR offers and a payer-by-payer answer when an in-network offer arrives.
Early access
- A decision report when a contract offer or termination lands
- Rate exhibits for IDR briefs, each with its source file
- Your own allowed amounts as payers report them
- Texas, Oklahoma and Kansas first
The problem
The files are changing
From April 1, 2027 plans post rate files per provider network, every quarter, each with an attestation and a named senior official.25
Networks are moving
Texas ER physicians billing out of network fell from 58% in 2019 to 48% in 2023.23
Evidence has limits
IDR entities weigh information beyond the QPA. They may not weigh billed charges or Medicare and Medicaid rates.24
What you get
- A decision report per payer: in-network value against out-of-network value, with the assumptions on one page.
- Rate exhibits for IDR briefs, each tied to its source file and date.
- Your allowed amounts as payers report them, next to what you were paid.
- An alert when a payer’s posted rates for your codes move.
How it works
- 01
Tell us the decision.
A contract offer, a renewal or a termination notice.
- 02
We pull the files.
The payer’s published rate files, for your codes and market.
- 03
You get the report.
In-network against out-of-network, payer by payer.
Who it is for
- ER groups and freestanding ERs weighing a payer contract
- Anesthesia and radiology groups facing a renewal or termination
- Revise IDR clients, for stronger offers
What we never do
- Share your rates with other clients or with payers
- Tell competing groups what to charge
Pricing
Pricing at early access.
What does Rates tell us?
Whether a payer’s in-network offer is worth more than staying out of network, payer by payer, with the assumptions on one page. It also turns payer rate files into exhibits for your IDR offers.
When would we use it?
When a contract offer, a renewal or a termination notice arrives, and when you build offers for IDR.
Where do the numbers come from?
The rate files plans must publish under federal rules, plus your own remits. Each exhibit names its source file and date.
Who sees our rates?
Your team. Your rates stay in your account. We never share them with other clients or with payers.
Do you negotiate our contracts?
No. We give you the numbers. Contract terms stay with you and your counsel.
Which states, and what does it cost?
Texas, Oklahoma and Kansas first. Pricing is set at early access.
Sources
- 23Texas Department of Insurance, Balance Billing Biennial Report, November 2024: 64.29% of arbitration and 74.91% of mediation requests settled in the first 30 days (2020 to 2023); ER doctors billed as out-of-network fell from 58% (2019) to 48% (2023). Source
- 2442 U.S.C. 300gg-111(c): open negotiation, payment of an amount agreed in open negotiation within 30 days, and what an IDR entity may and may not consider. Source
- 25Transparency in Coverage final rules, 91 FR 63748, October 6, 2026: an in-network rate file for each provider network, applicable March 6, 2027 and posted quarterly from the first quarter after (April 1, 2027), each carrying the plan's attestation and the name of its CEO, president or designated senior official. Source
Help us build it. Use it first.
We are taking a small number of design partners for each new product. Tell us what you need. We reply within one business day.