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Transparency
Announcing our Payer Price Transparency Analytics Portal & API
Serif Health is excited to announce that we have achieved nationwide coverage of payer pricing data, available via our analytics portal or our new documented REST API. That’s right, we have price data coverage for insurance payers in every state in the US, including Hawaii and Alaska. The API is convenient, lighting fast, and scalable up to millions of queries per month - contact us for a test API key today!
Published
3/31/2023
Hello, healthcare price transparency fans! Since the payer files came out on July 1st, we’ve been hard at work analyzing, understanding, and indexing the data.
Serif Health is excited to announce that we have achieved nationwide coverage of contracted fee-for-service rate data. That’s right, we have data coverage for contracted fee-for-service rates between providers and insurance payers in every state in the US, including Hawaii and Alaska. We’ve indexed data from the national PPO networks from Cigna, Humana, Aetna and UHC, the BCBS national preferred provider reciprocity network, many state specific plans and BCBS organizations, as well as multi-state payers like Kaiser, Molina, Bright Health, and more.
Best of all, this data isn’t locked up in a multi-terabyte data warehouse, and it doesn’t require a bulk data purchase or data science team to be useful. It’s indexed and available for our customers through the Serif Health analytics portal. You can easily visualize data in a region, and drill down by code, price tier, site of service, and payer.
For customers who might need higher scale, advanced analytics, or direct integration of the pricing data into your applications, we expose the pricing data through our new Payer Reimbursements API. The API is convenient, lighting fast, and scalable up to millions of queries per month. Documentation can be found here: https://pricing-api.serifhealth.com/docs/.
Our API allows you to query for payer reimbursement rates for individual procedure codes, easily filtered down to by region, tier, payer and site.
> curl "https://pricing-api.serifhealth.com/v1/rates/code/27445?region=PA&tier=professional"
{"code":"27445","count":3178,
"rates": [
{"npi_count":3509,"ein_count":2,"payer":"Cigna","rate":1621, ...},
{"npi_count":2,"ein_count":2,"payer":"UHC","rate":1412, ...},
...
]
}
If you’re interested in percentile distributions for a specific market, our distributions endpoint makes it simple:
> curl "https://pricing-api.serifhealth.com/v1/distributions/code/90837?region=TX&tier=professional&site=nonfac&payer=bcbs&weighting=ein"
{"code":"90837","npi_count":1128940,"ein_count":270301,"weighting":"ein","distribution":{"5th":92.04,"10th":92.04,"25th":103.06,"50th":126.69,"75th":133.86,"90th":162.07,"95th":179.27}}
Our team can also handle custom data pulls for data by specific EINs, NPIs, or taxonomy codes - and results can be indexed into the API by request.
Monthly pricing for the portal and API starts at just $1,000 a month - a price point thousands of dollars cheaper than other data vendors in the market. That $1,000 price point enables access to an entire US region, not just one state, and unlike other data vendors, we don't contractually demand severe restrictions around caching and IP rights.
If you’re looking for pricing data for benchmarking, payer performance, network analytics, or patient price estimates, contact us today and we can provide you with a test key.