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We analyze thousands of Payer TiC files. View our Payer TiC Quality Ratings.

We provide curated data and payer analytics for value creation

IS THIS YOUR ROLE AND A PROBLEM TO SOLVE? WE HAVE THE ANSWER.

The CFO's problem

"My payer contracts are outdated and my organization is underpaid relative to my peers. I need objective information to compare my rates to the market and capture the revenue opportunity."

Our solution

Use our validated and normalized Transparency in Coverage data, our streamlined benchmarking and revenue opportunity analysis and contracting support. Level the playing field today.

The CRO's problem

"My provider team's unit productivity and quality metrics are great but revenue productivity hasn't improved. I need to reset our payer rate cards to grow revenues and reward my providers."

Our solution

Use our validated and normalized Transparency in Coverage data, our competitor benchmarking and revenue opportunity analysis to support win-win payer discussions. Reward your hard-working providers!

The VP Managed Care's problem

"I've got dozens of payer relationships to manage and daily analysis requests from my CFO and acquisitions team. I need better and faster tools to get things done!"

Our solution

Use our apps including Medlyze Mentor to quickly get answers to your current contract terms, Medicare and Medicaid rates. Pull up market benchmarking analysis in minutes vs days. We make time for you to be more proactive and a great business partner!

The Chief Actuary's problem

"Does my health plan really have to increase unit costs that much for this health system to renew our contract? Will we be overpaying relative to our peer health plans?"

Our solution

Compare your unit costs to peer health plans using our unit cost analysis dashboards. See how your unit costs compare for all providers in your network. Get complete transparency to where your plan stands.

The CIO's problem

"How will I ingest a Terabyte of price transparency data for my team, master it, and then provide cutting edge analytical tools to my finance and managed care teams? There's not enough time or resources!"

Our solution

Use our APIs to tap into data and analysis on-demand. Or we can host data, customize analysis and maintain it while also providing your team domain expertise. We are an extension of your team!

Learn About Our Portal Solutions

We solve your five biggest payer analytics challenges.

1. No visibility to market rates

You don't have your own contracted rate fee schedule and you don't know how it compares to others in your market

2. No leverage with payers

You don't have the right contacts, objective data nor strategy to successfully negotiate improved contracted rates with your payers

3. Manual effort to manage data

You are overwhelmed by the sheer volume of market rates and claims volume data to be able to manage it with your technology

4. Lack of analytical resources

Your team doesn't have the time nor the capability to structure analyses based on large data sets and calculations needed for insightful answers

5. Analysis is very complex

You are not familiar with the best practices used to perform complex analysis and withstand scrutiny by leadership or negotiating parties

Medlyze takes the pain out of payer analytics and makes value-creation enjoyable. Here's how...

Market Rate Benchmarking

Use our curated and validated payer and hospital price transparency data to see exactly where your reimbursement rates stand in the market.

Get instant visibility to your own contracted rates and compare them with others in your market.

Pricing is based on needed payers, hospitals and markets.

Medlyze Mentor

Medlyze Mentor^TM our generative AI assistant gives instant answers to questions about your data without burdening your analytical teams with lots of queries.

Overcome manual effort to manage data and lack of analytical resources.

Pricing is based on subscription.

Customized Analytics Apps

Medlyze's Apps make your life easier. Access reference tools, or take insights to a higher level with custom dashboards for your organization's value-creation needs.

Integrate large and complex data into easy-to-understand dashboards to support strategic decision making.

Pricing is based on customer requirements.

Medlyze API Kits

Medlyze API Kits^TM gives your organization and clients immediate access pricing and volume data for use within enterprise systems and workflows.

Overcome manual effort to manage data and create additional insights for your team and clients.

Pricing is based on custom requirements.

What our clients are saying.

This is gold!

EVP and Chief Actuary, National Health Plan

Now we know we're now leaving money on the table in our managed care contract negotiations.

President, National Provider Network

You helped us see how much untapped opportunity there still is for us to grow.

CEO, National Provider Network

Representative clients (we respect client's confidentiality):

Wisconsin metropolitan health system
Minnesota metropolitan health system
Ohio metropolitan health system
National behavioral health platform
National dialysis services platform
Medical device and diagnostics manufacturer

New York multi-specialty provider group
National physical therapy platform
National cardiology platform
Payer integrity services provider
National endocrinology platform
National health plan

Join our Community of Payer Analytics Experts!

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Medlyze Pulse^TM
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