Clarify Health, a leading healthcare analytics and value-based payments platform company, announced the release of a no-code query engine within its Clarify Rates product, a price transparency intelligence software. Payers and providers can now instantly query 500+ terabytes of enriched price transparency data via the software’s user interface and generate reports on market prices in seconds. The Clarify Rates product contains institutional and professional rates from over 65 national and regional payers, including United Healthcare, Cigna, Aetna CVS, Humana, and many Blue Cross Blue Shield (BCBS) payers, and is constantly adding new data as it is released, providing access to the most comprehensive and up-to-date rate intelligence on the market.
“This unlocks the usability of the price transparency data,” commented Niall Brennan, Clarify’s chief analytics and privacy officer and head of the Clarify Health Institute. “It provides a business user on-demand, no-code access to the entirety of Clarify’s over 500 terabyte data set without needing a fully staffed data team to ingest, clean, and analyze it from massive and complex raw source files.”
Also Read: Patriot’s Accounting Software Ranked as Top 5 for Small Businesses
Raw price transparency data contains trillions of records, is inconsistently formatted, includes gaps in reporting, and paints a convoluted picture of healthcare pricing in the commercial market today. Aside from its no-code query engine, what makes Clarify Rates unique is its enriched rates data. By enriching raw rates with claims data on 300M+ annual lives, the product displays prices that have been billed instead of millions of meaningless prices. Clarify’s data enrichment methodology uses claims volume to determine utilization and remove “zombie rates,” rates that are reported for providers who never have and would never provide certain services.
The methodology also maps standard codes to service lines, estimates Medicare payments for those services, and calculates rates as a percentage of the Medicare payment. Additionally, by integrating insights from claims alongside rates data, Clarify adds the critical dimensions of service mix and volume. This enables the display of the weighted percent of Medicare prices (versus straight average) so users can better inform their understanding of the true economics and value delivered.
SOURCE: Businesswire