Which providers in your network are paid most for the same code? The answer should come from the files, not from memory.
Medlyze sets what hospitals and competing payers have published for the same codes beside your own rates, by market and provider, each with its source.
Use it to find cost outliers in a network, benchmark rates against competing payers, design a network by market, or check a transparency file before it is published.
Send a market, a line of codes and the payers you compete with. You get the published rates side by side, within 24 hours.
What changes when the decision is made on the rate of record.
Four New York payers publish four different medians for the same code.
Real published commercial rates, by payer and hospital. Your markets and codes come in the same record.
Dot = median · thin line = lowest to highest rate · shaded bar = middle half of a payer’s providers
Market view
What competing payers and hospitals have published for your codes, by market and provider.
Outliers
Providers paid furthest from the market for the same code, ranked.
File quality
Your transparency file graded against the CMS schema, with the issues named.
Payer ratings →Can we audit our own file?
Yes. The payer ratings grade every file we track against the CMS schema and name the issues found. Ask for the detail behind your grade.
We have an analytics team.
They have your data. The record adds every competing payer’s published rate and every hospital’s, matched and checked, so they spend their time on the decision, not the files.
How accurate are the published rates?
They are the payers’ and hospitals’ own filings, validated against the CMS schemas and graded A to F. Each rate carries its file and date, so a figure can always be traced.