Data-Driven Healthcare Intelligence
From market intelligence to clinical optimization, we provide the tools and insights to optimize revenue, reduce costs, and improve outcomes.
Our Products
Market Data Insights
Payer and hospital price transparency data for revenue and cost optimization.
Key Benefits:
- ✓Access millions of pricing data points from 500+ payers and hospitals
- ✓Competitive rate benchmarking by geography and specialty
- ✓Market trend monitoring and alerts
- ✓Evidence-based negotiation strategies
Managed Care Workflow Optimization
Contract management and value maximization for payer relationships.
Key Benefits:
- ✓Centralized contract repository and tracking
- ✓Automated rate escalation monitoring
- ✓Renegotiation opportunity identification
- ✓Pro forma modeling for contract scenarios
Value-Based Care Operations
Clinical resource, outcomes, and financial optimization under value-based models.
Key Benefits:
- ✓Predictive care planning recommendations
- ✓Quality measure performance tracking
- ✓Resource utilization optimization
- ✓Risk-adjusted payment modeling
Provider Revenue Integrity
Validate claims payment per contract terms and recover underpayments.
Key Benefits:
- ✓Automated contract-to-payment matching
- ✓Underpayment identification and quantification
- ✓Appeals documentation generation
- ✓Revenue leakage dashboards
Employer Benefits Optimization
Claims-based carrier optimization for employers and brokers.
Key Benefits:
- ✓Claims-based carrier performance analysis
- ✓Network adequacy and cost evaluation
- ✓Plan design optimization modeling
- ✓Year-over-year cost trend analysis
Home Health Care Orchestration
Predictive analytics for home health agencies under CY 2026 Medicare rules.
Key Benefits:
- ✓LUPA avoidance predictions ($200-400/episode savings)
- ✓HHVBP score optimization (up to +5% payment adjustment)
- ✓Care orchestration recommendations
- ✓Margin analysis dashboards
APIs for Data Integration
Seamlessly integrate healthcare price transparency data into your existing systems.
Key Benefits:
- ✓RESTful APIs with comprehensive documentation
- ✓Real-time data feeds with 99.9% uptime SLA
- ✓Flexible data formats (JSON, CSV, XML)
- ✓Dedicated technical support and integration assistance
Customized & White-Labeled Portals
Access our solutions through fully customized or white-labeled portals tailored to your brand and workflow needs.
Key Benefits:
- ✓Fully branded portal matching your company identity
- ✓Custom dashboards and workflows for your specific use cases
- ✓Multi-user access with role-based permissions
- ✓Ongoing feature enhancements and dedicated support
Solutions by Customer Segment
Healthcare Providers
Hospitals, clinics, and medical practices
Recommended Solutions:
- • Market Data Insights
- • Managed Care Workflow
- • Revenue Integrity
Healthcare Insurance Companies
Payers and health plans
Recommended Solutions:
- • Market Data Insights
- • Value-Based Care Operations
- • APIs for Data Integration
Healthcare Technology Companies
HIT vendors and solution providers
Recommended Solutions:
- • APIs for Data Integration
- • Customized Portals
- • Market Data Insights
Revenue Cycle Management Companies
RCM service providers
Recommended Solutions:
- • Revenue Integrity
- • Market Data Insights
- • APIs for Data Integration
Employer Health Insurance Brokers
Benefits consultants and brokers
Recommended Solutions:
- • Employer Benefits Optimization
- • Market Data Insights
- • Customized Portals
Workers Comp & Personal Injury Legal Advisors
Legal professionals handling healthcare claims
Recommended Solutions:
- • Market Data Insights
- • APIs for Data Integration
Testimonials
“Before working with Medlyze, we were struggling through payer negotiations with no visibility in market rates and little leverage to improve our low reimbursement rates. Medlyze provided the exact support we needed by exposing competitor rates and delivering a clear contract negotiation strategy, finally giving us the data to align our approach. Now, we are positioned to increase our rates with our current payer and have a replicable strategy for future contracts with companies like Cigna.”
Urology Practice Owner
Owner, Colorado Urology Practice
“This is Gold!”
Actuary
Actuary, BCBS Plan
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