Know Your Real Payer Network Coverage — By State, By Product, By Carrier
We resolve your existing payer contracts against a validated national enrollment dataset to show your actual contracted market share — and rank the highest-value contracting opportunities you're missing.
Pilot one state first · Pricing scales with contract volume · No paid data subscription required
Sound Familiar?
No Visibility Into Real Coverage
You know how many contracts you've signed. You don't know what share of covered lives that actually represents, by state or by product.
Expensive Data That Still Needs Manual Work
Paid data subscriptions are costly — and they still leave you to resolve contract names to their data and calculate share yourself.
Contract Names Don't Match Enrollment Data
The same payer shows up under a dozen different legal entity names and plan brands across states — matching your contract list to real enrollment data by hand doesn’t scale.
No Way to Prioritize Contracting Effort
Without a ranked view of covered lives by payer and state, contracting teams chase the loudest opportunities instead of the biggest ones.
A Validated National Enrollment Reference
We maintain enrollment data covering commercial, Medicare, Medicare Advantage, Medicaid, and Managed Medicaid across all 50 states — built from public regulatory filings and cross-validated against independent government sources, not a single-source estimate.
- Five lines of business, one dataset: commercial, Medicare, Medicare Advantage, Medicaid, and Managed Medicaid
- Every figure checked against a second independent source before it’s used
- No dependency on paid subscriptions
Your Contracts Resolved to Real Payer Identities
However inconsistent your contract list is — legal entity names, regional licensee variants, ambiguous abbreviations — we match each contract to a canonical payer identity using name and state, with a documented fallback process for the ones that don’t resolve cleanly.
- Handles regional licensee variants (e.g., state-specific Blue Cross Blue Shield entities)
- Flags ambiguous matches for review rather than guessing
- Works from whatever contract data you already have — full exports or partial lists
Current Share, Sliced However You Need It
See your contracted coverage nationally by state, nationally by carrier, or drilled into a single state broken down carrier-by-carrier — down to the individual plan product for Medicare Advantage and Medicaid.
- National totals by state, and by carrier
- Any single state, ranked by carrier
- Plan-product-level detail for Medicare Advantage and Medicaid
A Ranked List of Where to Contract Next
Every uncontracted or under-penetrated payer is ranked by covered lives in your footprint — so your team spends time pursuing the opportunities worth the most, not just the ones you happen to know about.
- Whitespace ranked by state and product, not just aggregated nationally
- Built directly from your existing state footprint, not a generic market report
- Delivered as a working reference dataset your team can query going forward, not a static PDF
A Subscription Gives You Data. This Gives You an Answer.
Static data subscriptions hand you a national dataset and leave the hard part — resolving it to your contracts — to you. We do that work as part of the analysis.
How It Works
Share Your Contract List
Send us your payer contracts — even a partial export with contract name, state, and line of business is enough to start. A payer ID from your EDI/billing system, if you have one, speeds up matching further.
We Pilot One State First
Before committing to a full rollout, we run the complete analysis — contract resolution, current share, and ranked whitespace — on a single state you choose, sized to keep the pilot fast and low-cost.
Scale to Your Full Footprint
Once the pilot validates the approach, we roll out the same analysis across every state you operate in, with pricing that scales with your contract volume, not a flat per-state rate.
Pilot First, Then Scale
Pricing is scoped to your contract volume, not a flat per-state rate — and your pilot fee is always credited toward the full rollout.
Pilot
Validate the approach on one state before committing further.
Fixed fee, scoped to a single state — credited in full toward the full rollout if you move forward
- Contract-to-payer resolution for one state
- Current share by product for that state
- Ranked whitespace and contracting opportunities
- Findings delivered within days, not weeks
Full Rollout
Every state you operate in, one comprehensive view.
Volume-based pricing tied to your total contract count — the pilot fee is credited toward this cost
- Everything in the pilot, extended to your full state footprint
- National view by carrier and by state
- Cross-state whitespace ranking, prioritized by covered lives
- Ongoing access to the underlying reference dataset
Frequently Asked Questions
Ready to See Your Real Coverage?
Pick one state, send us your contract list, and get a ranked view of your current share and your biggest contracting opportunities — before committing to anything beyond a single-state pilot.
No commitment beyond the pilot · We respond within 1 business day