Price Transparency Data & Reimbursement Rates FAQs

Question 1

What is price transparency data?

Accepted Answer

Price transparency data is publicly available information mandated by federal law that reveals the exact negotiated rates between healthcare providers and insurance companies. If you've ever wondered, "How much does insurance reimburse my competitors?" this data provides the exact dollar amounts, removing the guesswork from healthcare billing and contracting.

Question 2

Why is Keeper's price transparency data so affordable?

Accepted Answer

We've built Keeper to be lean and highly efficient so we can pass those savings directly to you. We are optimizing for scaling our business like a tech company; democratizing access to the data and driving the cost burden of parsing MRF data to zero via a large userbase.

Question 3

How can I use this data to improve my business?

Accepted Answer

If you are asking yourself, "What are my reimbursement rates compared to the clinic across the street?" this data is your answer. You can use our insights to see exactly how different payers are reimbursing competitors in your specific market. This allows you to negotiate stronger payer contracts, uncover underpayments, and set more competitive pricing.

Question 4

Where do you get this insurance reimbursement data?

Accepted Answer

We source our information directly from the Machine-Readable Files (MRFs) published by health insurance payers, as mandated by the federal Transparency in Coverage (TiC) rule. We ingest these massive, complex files and process them into clean, actionable price transparency data that you can actually use.

Question 5

What fields are included in your negotiated rates data?

Accepted Answer

Our clean datasets include all the critical fields you need including: Billing Codes and Type (CPT/HCPCS/DRG), Provider NPI and Name, EIN and Business Name, Payer/Insurance Company Name, Place of Service (Facility vs. Non-Facility), Billing Code Modifiers, Fee Schedule levels, negotiation type, and the negotiated rates.

Question 6

Who is currently using this data to maximize reimbursements?

Accepted Answer

Our clients include Physicians, Revenue Cycle Management (RCM) companies, and Ambulatory Surgery Centers (ASCs). They rely on our how much does insurance reimburse data for everything from winning aggressive contract negotiations with payers to pinpointing high-value lead generation targets.

Question 7

Why use a price transparency vendor to find negotiated rates?

Accepted Answer

Because the raw payer files are notoriously massive, messy, and disorganized. It takes highly technical data engineering teams months to download, parse, and figure out how to work with them. We have already done all the heavy lifting and dirty work so your team can focus on using the negotiated rates to grow your business.

Question 8

Is it legal to look up competitor reimbursement rates? What does the law say?

Accepted Answer

Yes, it is 100% legal. In fact, it's federally mandated. The Transparency in Coverage (TiC) rule and the Hospital Price Transparency rule require payers and hospitals to publish these exact negotiated rates publicly. The government created these laws specifically so the public and providers could see exactly how healthcare services are priced.

Question 9

Why choose Keeper for price transparency data?

Accepted Answer

We do one thing exceptionally well: get you accurate negotiated rates at an affordable price. By keeping our focus laser-sharp, we have the time and resources to be there for our clients with hands-on support whenever they have questions about their market's reimbursements.

Question 10

Why should I check my negotiated rates today, rather than later?

Accepted Answer

Because every day you wait is a day you are potentially being underpaid for the procedures and visits you are already performing. Our clients see an immediate ROI by using our price transparency data to identify where they are leaving money on the table.

Question 11

How often is the data updated?

Accepted Answer

Healthcare pricing data is updated quarterly to ensure you have access to the most current negotiated rates and reimbursement rates. Insurance companies are required by federal law to update their machine-readable files monthly, and we process these updates to provide you with clean, organized price transparency data every quarter.

Question 12

Which insurance companies are included in your negotiated rates data?

Accepted Answer

Our platform includes negotiated rates from all major insurance companies including Blue Cross Blue Shield, UnitedHealthcare, Cigna, Aetna, Humana, Kaiser Permanente, and many regional insurers. We cover over 95% of the commercial insurance market's reimbursement rates in the United States.

Frequently AskedQuestions

What is price transparency data?

Why is Keeper's price transparency data so affordable?

How can I use this data to improve my business?

Where do you get this insurance reimbursement data?

What fields are included in your negotiated rates data?

Who is currently using this data to maximize reimbursements?

Why use a price transparency vendor to find negotiated rates?

Is it legal to look up competitor reimbursement rates? What does the law say?

Why choose Keeper for price transparency data?

Why should I check my negotiated rates today, rather than later?

How often is the data updated?

Which insurance companies are included in your negotiated rates data?

Still have questions about reimbursement rates?

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