A disputed medical bill is argued against a number. The number should have a source.
Medlyze provides what hospitals and payers in the same market have published for the same services, each with its source: the benchmark for bill review, negotiation and testimony.
Use it to evaluate a disputed bill, set a settlement position, support an expert’s testimony, or decide which cases to contest.
Send one bill’s codes, provider and state. You get the published benchmarks beside each line, within 24 hours.
What changes when the decision is made on the rate of record.
Four payers, four medians, one code. A disputed line is judged the same way.
Real published commercial rates for New York, by payer and hospital. A bill’s codes, provider and state come in the same record.
Dot = median · thin line = lowest to highest rate · shaded bar = middle half of a payer’s providers
Benchmarks per line
Each billed code against the published rates for the same service in the same geography.
See a sample report →Provenance
The file, date and method behind every figure, documented for the record.
Geography
By state, metro area and ZIP, so the local market is the comparison.
Is the data defensible?
It comes from CMS-mandated transparency filings, validated against the federal schemas. Each rate carries its file and date, and we provide provenance documentation for proceedings.
What about workers’ comp fee schedules?
Where a fee schedule applies it governs. The published rates matter where it does not: out-of-network charges and disputed reasonableness.
Do you provide expert witnesses?
No. Billing experts and health economists use the data in testimony; we support them with documentation.