Serif Health Blog
Featured · Use Cases
5 min read
From Compliance to Competitive Edge: How Health Systems Are Using Price Transparency Data
Health systems are moving beyond compliance and using price transparency data as a strategic intelligence function for contracting, benchmarking, growth, and market planning. Learn the five capabilities leading organizations are building to operationalize pricing intelligence across the enterprise.
Serif Health Team 
Use Cases
5 min read
Repricing at Scale: From Claims Validation to Strategic Insights
Understand how price transparency enables claim-level repricing at scale—unlocking full-book audit, variance tracking, and network-level cost insights across providers and systems.
Whitney Adair · APR 17, 2026 .webp)
TiC Takes
14 min read
AI-Enabled Medical Devices: Clinical Artificial Intelligence Arrives
AI-enabled medical devices and associated clinical procedures have moved from mere buzzwords to reimbursed reality. We explore what national price transparency and claims data can show about coverage, in-network reimbursement, and adoption across this fast-growing category.
Bill Pajerowski · APR 8, 2026 
TiC Takes
13 min read
What Payers’ Out-of-Network Allowed Amount Files Reveal (and Why It Matters)
A data-driven look at what Transparency in Coverage OON files actually contain—from inpatient DRG dominance to large billed-vs-allowed gaps—and why the data is both incomplete today and increasingly important.
Bill Pajerowski · MAR 12, 2026 
Healthcare
12 min read
How Price Transparency Data Explains Aetna’s ACA Market Exit
Using standardized Transparency in Coverage data across 16 states, we analyze how Aetna’s negotiated Exchange rates, network expansion, and premium growth compared to peers like UnitedHealthcare and Cigna. The data show Aetna paying materially higher rates—particularly for inpatient services—placing it at a structural disadvantage in the price-sensitive ACA marketplace and helping explain its 2026 exit.
Bill Pajerowski · MAR 1, 2026 .webp)
MRFs
12 min read
TiC 2.0 Adoption: Real Progress, Partial Compliance, and a Few New Headaches
CMS was explicit about the goals of TiC 2.0: reduce duplication, normalize file structure, and make machine-readable files more usable at scale. One month in, we’re seeing meaningful progress—and some familiar patterns of “compliance in name only.” But as always with TiC, the details matter. In this edition of MRF Processing Notes, I’ll break down the adoption of 2.0 and where it’s helping (or hurting) the cause of usable transparency data.
Matthew Robben · FEB 23, 2026 
Technical Deep Dive
6 min read
Making Sense of Healthcare Data: How We Solved the Plan Name Matching Problem
Turning messy payer and plan names into standardized, trustworthy data for healthcare price transparency.
Shlomtzion Hazan · FEB 3, 2026 
Use Cases
5 min read
Benchmarking Commercial Rates Against Medicare: Why the Anchor Still Holds
Commercial healthcare prices often appear chaotic in dollar terms, but a clearer pattern emerges when rates are benchmarked to Medicare. This post explains why Medicare remains the most reliable reference point for interpreting price transparency data, how benchmarking helps normalize variation across service lines and markets, and where differences in commercial rates reflect meaningful signals rather than noise.
Bill Pajerowski · JAN 27, 2026 .webp)
Policy and Government
6 min read
The Great Healthcare Plan Promises to “Maximize Price Transparency”—Here’s What That Means
The Trump administration’s most recent announcements on healthcare affordability are full of transparency actions—mandating that all providers and health insurers meaningfully post their pricing.
Bill Pajerowski · JAN 17, 2026 .webp)
MRFs
7 min read
Exploring Florida Blue “Aggregated Networks”: What Longitudinal Aggregation Fixes—and What It Doesn’t
In this analysis, we test whether aggregating Florida Blue’s machine-readable files across 18 months meaningfully closes known data gaps.
Matthew Robben · JAN 6, 2026 
Policy and Government
10 min read
Transparency in Coverage Evolves: CMS Signals a More Usable, Sustainable Data Future
CMS’s latest proposed update to Transparency in Coverage signals a meaningful shift—from publishing more data to making price transparency data actually usable.
Bill Pajerowski · DEC 23, 2025 .webp)
Company Updates
4 min read
MCP From Prototype to Production: How We Built Serif Health’s Remotely Hosted and Secure MCP Servers
How we scaled MCP from a local prototype to two production-grade servers, tackling key challenges in authentication, architecture, and schema design to enable secure LLM access to price transparency data.
Aaron Berns · DEC 8, 2025 
MRFs
5 min read
You Can’t Benchmark with Payer Files Alone: A Percent-of-Charges Case Study
Learn why percent-of-charges contracts can’t be benchmarked with payer files alone—and how combining payer TiC, hospital MRFs, and claims reveals true market cost.
Company Updates
2 min read
Building Trust Through Compliance: Serif Health Completes SOC 2 Type II Audit
Serif Health successfully completed its SOC 2 Type II audit with Advantage Partners, supported by Vanta’s automated compliance platform—reinforcing its commitment to secure, reliable healthcare data infrastructure.
Whitney Adair · NOV 10, 2025 
Company Updates
3 min read
Get the Whole Picture: Full Hospital & Provider Fee Schedules in Seconds
Access complete hospital and clinic fee schedules instantly with Serif Health’s new Fee Schedule Lookup in Signal. Explore provider contracts, codes, and rate benchmarks in one click.
Blake Birmingham · NOV 6, 2025 .webp)
Company Updates
4 min read
Access Is the Next Step in Price Transparency—and AI Is Making It Possible
Learn how Serif Health uses AI and the Model Context Protocol (MCP) to make healthcare price transparency data more accessible, actionable, and secure—unlocking new ways to explore cost and network insights.
Aaron Berns · OCT 30, 2025 
MRFs
6 min read
The Hidden Codes That Break Your Price Transparency Analysis
Custom (CSTM) and Local (LOCAL) codes often contain critical negotiated rate data that many vendors ignore. Learn how Serif Health normalizes these payer-specific codes to ensure your price transparency analytics are complete and accurate.
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Policy and Government
6 min read
As the Government Shuts Down, a New TiC Schema Drops–and Leaves Big Questions
The new Transparency in Coverage (TiC) Schema 2.0 introduces key updates to provider identification, DRG pricing, plan sponsor fields, and out-of-network thresholds—while raising new questions about enforcement, validator tools, and custom code use.
Matthew Robben · OCT 8, 2025 .webp)
Company Updates
5 min read
Announcing Our Live Payer Inventory: Real-Time Transparency from Serif Health
See Serif Health’s live network quality scoring across 200+ payers, with monthly updates on transparency data completeness and reliability.
Matthew Robben · SEP 17, 2025 
Use Cases
4 min read
Why “Discounts” Aren’t Enough: How Employers Actually Move the Needle on Healthcare Costs
Discounts aren’t enough. This blog breaks down how employers can move beyond percent-of-billed charge arrangements and use cost intelligence to evaluate networks, steer care, and design smarter benefit strategies.
Whitney Adair · SEP 12, 2025 
MRFs
5 min read
Cleaning Up the Noise in Anesthesia Rates
How Serif Health Standardizes Anesthesia Reimbursement Across Payers
Shlomtzion Hazan · AUG 20, 2025 
Healthcare
4 min read
Total Cost of Care Is the New Benchmark for Reducing Employer Healthcare Costs
Employers and their advisors are redefining benefits strategy with a new benchmark: Total Cost of Care. See how real-time data helps forecast benefits spend and guide smarter healthcare decisions.
Whitney Adair · AUG 15, 2025 .png)
MRFs
6 min read
What Price Transparency Data Teaches Us About Keytruda
What can we learn from price transparency data for physician-administered drugs? New data on Keytruda highlights wide variation in commercial reimbursement: across states, by payer, and based on provider characteristics like place of service. A single treatment for this high-cost infusion can range from under $12,000 to over $30,000, depending on where it’s given, which payer is involved, and how it’s billed.
Bill Pajerowski · AUG 3, 2025 .png)
Policy and Government
4 min read
Prescription Drug Price Transparency: Our Response to the Federal RFI
Serif Health recently submitted both an independent and joint coalition response to the federal government’s Request for Information on prescription drug price transparency. Drawing on our national TiC data from June 2025, we demonstrate that infrastructure already exists and offer clear recommendations to ensure that negotiated drug prices become fully visible, comparable, and actionable.
Bill Pajerowski · JUL 14, 2025 .png)
Healthcare
6 min read
Starting with Why: Price Transparency and the Future of Healthcare Markets
Healthcare markets fail because prices are hidden, but Serif Health is building transparency tools to make pricing visible and actionable. By creating the most comprehensive database of negotiated rates, we're helping stakeholders understand value and improve patient access across the US healthcare system
Bill Pajerowski · JUL 8, 2025 .png)
Healthcare
6 min read
Understanding Behavioral Health Reimbursement: Transparency Data, Trends, and Tactics
The behavioral health market is experiencing unprecedented growth and transformation. In this article, we analyze behavioral health trends and reimbursement rates using 2025 machine-readable files, with examples from real payer-MSO relationships.
Blake Birmingham · JUN 18, 2025 .png)
MRFs
7 min read
Analyzing Inpatient Hospital Pricing Using Price Transparency Data
Price transparency files are incredibly valuable for finding up-to-date pricing on hospital reimbursement, but you need a partner who knows what they are doing.
Policy and Government
4 min read
Price Transparency Accelerates: May 2025 Policy Shakeups and What Comes Next
Following February’s Executive Order, CMS, the Labor Department, and the Treasury Department recently dropped new guidance that pushes us further toward standardization, enforcement, and real usability of price transparency data. At Serif Health, we’ve always believed transparency data only matters if it can be trusted, compared, and acted upon. Recent updates show the federal government is continuing to lean in toward these goals.
Bill Pajerowski · JUN 2, 2025 
Use Cases
5 min read
Baselining price transparency data to Medicare
Uncovering key contracting terms from machine readable files by joining to CMS datasets.
MRFs
11 min read
Would Florida Blue Be in the Red if TiC Were Enforced?
This blog post answers a big what-if question: what if the Transparency In Coverage laws were actually enforced and penalties were administered to the entities that are either not posting machine readable files, or are posting files which are obviously incomplete? How financially impacted would those entities be? Read on to see the high level math, as well as our quarterly lay-of-MRF-land with this installment of “MRF Processing Notes”.
Matthew Robben · APR 8, 2025 
Company Updates
3 min read
Historical price transparency data trends
Example insights you can draw from comparing machine readable file data over time.
MRFs
5 min read
Impact of Zombie Rate Filtering For TiC Data
In a prior post, we covered the Serif Health approaches for zombie rate filtering, and the volume of data impacted by different filtering approaches. Our question for this blog post is: what impact does all this data in the raw file have on the resulting distributions, and where do distributions land when the data is removed?
Matthew Robben · MAR 13, 2025 .png)
Company Updates
3 min read
Announcing The Serif Health 'Find Care' API: Seamless Provider Search via Price Transparency
Designed for third-party administrators (TPAs) and health plans, this API can transform how you deliver provider and facility search experiences to your members.
Matthew Robben · JAN 6, 2025 
Company Updates
3 min read
Launching Serif’s AI Assistant
Your personal analyst for working through price transparency data
MRFs
7 min read
Automating Hospital Price Transparency v2 Data Collection
The Hospital Price Transparency “v2” Schema rolled out in July of 2024 had the potential to greatly increase data accessibility and standardization. We’ve been implementing automated data collection pipelines on the v2 schema, and are excited to report that we do indeed see significant improvements in data quality and availability. But as with any rule, there’s plenty of rule breakers out there. Read on to see how HPT v2 changes the landscape for hospital data gathering, what’s working, and where the hard parts still are.
Matthew Robben · NOV 4, 2024 
MRFs
4 min read
Provider Directory Use Cases
Some learnings from spending years inside payers’ machine readable files with our customers.
MRFs
7 min read
Zombie Hunting: Filtering Approaches for Price Transparency Data
Payer machine-readable files (MRFs) are filled with irrelevant "zombie rates"—like a mental health provider billing for a knee replacement. Learn how we use claims data and taxonomy mapping to filter out these misleading records, streamlining data for faster, more accurate search results.
Use Cases
4 min read
The Power of Historical Price Transparency Analysis - Available to All Serif Health Customers
We are excited to share some of the latest price transparency use cases. Learn more about how our customers - from health systems and provider groups to employers and TPAs - are utilizing Serif Health's archived price transparency data to develop powerful historical analysis and insights.
Rafiq Ahmed · SEP 3, 2024 
Use Cases
2 min read
Announcing Serif Health’s Self-Serve Peer Benchmarks Report, Now Available to All Signal Customers
The latest addition to Serif Health’s platform, Signal, allows users to compare contracts across providers for easy, flexible benchmarking
MRFs
9 min read
TiC, ‘ToC’k: Hospital Price Transparency V2 Processing Notes
It’s been 25 days since the ‘V2 Schema’ for Hospital Price Transparency took effect in the market. So, is the data better? Is the workflow simpler? We’ve been looking into the new text and MRF files posted by many different hospitals, and we like what we’re seeing. So much so that we’re on a quest to gather all the hospital data…again. Read on for an early look at our experience with Hospital Price Transparency V2 MRF Processing and why we're excited to be gathering this data to complement our industry-leading portfolio of TiC files.
Matthew Robben · JUL 26, 2024 
MRFs
9 min read
Transparency Data Gets Harder to GET: MRF Processing Notes June 2024
Our June MRF Processing Notes blog focuses on a new behavior we are seeing with increasing consistency from UHC, Anthem, and various other BCBS Entities - rate limiting and/or blocking access to machine readable files. Read on for details.
Matthew Robben · JUN 20, 2024 
MRFs
4 min read
Keeping Our Network Library Up to Date (Part II): Isolating a Network
In our previous post on our monthly data ingestion process, we discussed what it takes to keep all of the Table of Contents (ToC) up to date across the varying Payors. But now that we have them, what exactly do we do with them? How do we go from a ToC file to defining what constitutes a PPO network and locating its associated files.
Derek Pedersen · JUN 6, 2024 
Company Updates
3 min read
Healthy Competition: Leverage Price Transparency for Peer Benchmarking
Signal’s latest report enables your practice to easily discover and compare contracted rates across a customized set of provider organizations.
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MRFs
5 min read
Seeing value-based contracts in the payer price transparency data
A set of examples for non-standard arrangements like service bundles, capitation agreements, and case rates present in the payer price transparency data.
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MRFs
3 min read
Technical Exploration of MRF Postings: How Useful is Negotiated Type?
The Serif Health data team is constantly investigating the technical nuances of the price transparency data. In this post, we explore the utility of the negotiated type field across payers and implications for Serif Health customers and users of the transparency data.
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Use Cases
3 min read
Using price transparency data to enhance your payer and growth strategy
Serif Health’s platform, Signal, makes it easy to factor in actual contracted reimbursement data into your expansion roadmap.
Use Cases
4 min read
Use Serif Health’s Price Transparency Toolkit to Drive Savings for Self-Funded Employers
As self-funded employers increasingly grapple with their role as fiduciaries for their employees’ healthcare, there is a unique opportunity to use price transparency data to drive substantial cost savings and improve employee healthcare. See how Serif Health has been working with health plans and self-funded employers to utilize price transparency data more effectively to build preferred provider networks and steer patients to low cost, high quality care on a consistent basis.
Rafiq Ahmed · APR 16, 2024 .png)
MRFs
6 min read
Exploring "Swiss Cheese" Machine Readable Files from Florida Blue
This March edition of MRF Processing Notes explores a Swiss Cheese MRF from Florida Blue's Blue Options PPO. There's some meat to the file, so it retains the shell of a compliant MRF, but otherwise has so many holes you can’t get the complete pricing picture for entities that matter. Interestingly, the gaps also shift month over month, suggesting with some nonintuitive analysis, it still might be possible to get useful price intelligence from the data.
Matthew Robben · MAR 13, 2024 
MRFs
5 min read
Keeping Our Network Library Up to Date: Indexing MRFs
Join us for a tale from MRF land about maintaining MRF indexes.
Derek Pedersen · MAR 5, 2024 .png)
Company Updates
2 min read
Announcing Signal by Serif Health
Cut through the noise with our new real-time rate search tool
MRFs
6 min read
Exploring New Prescription Drug Disclosures for Savings (and Sadness)
2024 comes with another big price transparency development - mandated prescription drug price disclosures. We’ve been keeping a close eye on the shifting disclosure timelines and enforcement ‘safe harbor’ rules regarding prescription drugs. The 1/1/24 deadline took a lot of folks by surprise, but not Serif Health - we’ve actively been refactoring our ingestion and parsing pipelines to handle this schema, so when 1/1 hit, we could easily leverage our existing ingestion and conversion pipelines to deliver prescription drug data in a preprocessed, normalized form to our customers. Read on for an analysis of postings from OptumRx and see which pharmacies rates are surprisingly non-competitive.
Matthew Robben · JAN 2, 2024 
Company Updates
3 min read
December Announcements: New Price Transparency Products and Updates from Serif Health
Serif Health's December product updates and new offerings for self-funded employers and TPAs
Rafiq Ahmed · DEC 17, 2023 
MRFs
7 min read
MRF Processing Notes - October Edition
Generally good news on macro posting and processing trends to report out this quarter. Many payers we’d highlighted for failing to post have returned to posting monthly, and we’ve seen meaningful improvements in posting size and EIN/NPI count increases came from payers like Aetna, Ambetter, Multiplan, and Priority Health. Of course, it wouldn’t be a processing notes post without some lowlights and public calling-outing - Optum and Florida Blue take the stage this month. Read on for details.
Matthew Robben · OCT 20, 2023 .png)
Policy and Government
4 min read
The Biden-Harris Parity Rule & The Current State of In-Network Mental Healthcare - How Far Do We Still Need to Go?
A quick look at how robust current provider networks are for mental healthcare using private insurance's machine readable files.
MRFs
15 min read
Baskets of Apples: Comparing reimbursements across plan MRFs
This month, we’ll demonstrate another use case for price transparency machine readable file (MRF) data by geographically mapping and comparing negotiated rates. You don't have to be a payer to pull this off - Serif Health has built tools that make getting clean data for analyses like this simple and cost effective.
Matthew Robben · AUG 21, 2023 
MRFs
11 min read
Apples to Crabapples: Comparing A Hospital MRF To A Payer MRF
So here we go, on our first blog really getting into the meat of MRF pricing info. We at Serif Health frequently get questions about hospital MRFs and how the quality compares to payer MRFs. Which data set is more trustworthy? Which should you use when? Is this easy to do? Is it ‘apples to apples’? Read on and find out.
Matthew Robben · JUN 30, 2023 
MRFs
7 min read
HealthSparq’s Non-Transparent Portal Allows Payers to Falsify Posting Dates
HealthSparq’s MRF portal allows payers to non-transparently forward date, backdate, and edit TiC postings without disclosure. Plus, we show you how to deal with BCBS of Minnesota's Imperva firewall which is improperly blocking machine access to their indexes.
Matthew Robben · MAY 23, 2023 .png)
Company Updates
2 min read
Introducing our New and Improved Serif Health Website
We are excited to announce the launch of Serif Health’s new and improved website: www.serifhealth.com! Enjoy a bolder, sleeker site design and user experience to better understand Serif Health, explore our enhanced MRF data product suite, and learn more about our mission to power price transparency in healthcare!
Rafiq Ahmed · MAY 12, 2023 
MRFs
6 min read
April MRF Processing Notes
We’re back for another round of MRF processing notes for April. For this month, we’ll go with a good, bad, and ugly approach. The good - some big payers posted more data (a LOT more). The bad - several BCBS entities didn't post or posted indexes full of links with March date codes. The ugly - Highmark.
Matthew Robben · APR 29, 2023 
Company Updates
6 min read
Announcing Serif Health, YC Winter '22 Alum
Serif Health was launched in November 2021 to improve US healthcare pricing. We (founders Matt and Rafiq) had existing healthcare and pricing backgrounds, and wanted to put that experience to use in service of making healthcare costs more transparent and affordable. We believe that better market analytics and intelligence, especially for smaller players in healthcare, can reduce the price disparities that exist today and better align incentives to help patients get the right care at a fair price.
Matthew Robben · MAR 31, 2022 .png)
Company Updates
2 min read
Announcing our $2.5M seed round!
We are proud to announce that we secured $2.5MM in venture funding, with backers including 1984 Ventures, Olive Tree Capital, Rebel Fund, and YC. Our angel investors include engineering and product executives from Dropbox, Airbnb, Pilot, Webflow, and more. We’re proud of our progress and incredibly thrilled to have the support and backing of an incredible investor team.
Rafiq Ahmed · JUN 2, 2022 Transparency
3 min read
First CMS Fines Issued for Price Transparency Non-Compliance
The CMS fine for Northside Hospital should be a major wakeup call to hospital systems around the country who have delayed compliance. It’s also an incentive for all insurance plans to post their in-network negotiated rate files by July 1 to stay in compliance with the upcoming effective date for the Transparency in Compliance act.
Matthew Robben · JUN 9, 2022 
Transparency
3 min read
Today is Payer File Release Day
Today marks a MAJOR breakthrough in healthcare, but it has nothing to do with cutting edge technology, historic procedures or drug approval. Yet the advancement has the potential to impact care for patients around the country. So what is this massive breakthrough? Simply put - payer network reimbursement files are now available to the public, cataloging every negotiated rate between every payer and provider in the country.
Matthew Robben · JUN 30, 2022 
Transparency
2 min read
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!
Matthew Robben · OCT 2, 2022 
MRFs
7 min read
A Primer on MRF Structure: How to Find a Rate
We get lots of outreach from folks who'd like to spot check an individual rate for price transparency purposes. You've probably heard there’s these Machine Readable Files out there that have this information. So, how do you get to the specific data you need? Let’s walk down the chain together, and learn about the different components of MRF postings (and health insurance networks) along the way.
Matthew Robben · OCT 13, 2022 
MRFs
17 min read
Learnings from MRF Land
Having trouble with Humana, Cigna, or Anthem MRF ingestion? Confused by the rates and place of service codes you're seeing in the file? In this post, we’ll lay out some of the key learnings and gotchas from our past few months of MRF processing, so you and your team don’t have to learn the hard way (like we did).
Matthew Robben · OCT 18, 2022 
MRFs
6 min read
November MRF Processing Notes
Hi folks! We’re back from HLTH, where the interest and excitement around the payer price transparency data was palpable. We wanted to give folks a November update on our MRF processing tips and tricks post... the TL;DR is that payers were responsive to feedback from MRF data processors like ourselves, and the MRF data is getting (slightly) easier to work with and understand. Read on for details!
Matthew Robben · NOV 29, 2022 
MRFs
6 min read
Happy Transparency New Year
Serif Health continues to examine and refine data to identify quality issues, reduce noise, and ensure our customers can make great decisions with trustworthy information. Key learnings and highlights for December: Taxonomy filtering is now available in our price dashboard and APIs, we found schema misuse leading to millions of ambiguous data points, and erroneous modifiers and TINs are present in various payer MRFs. Read on for more details.
Matthew Robben · DEC 29, 2022 
MRFs
2 min read
You don’t need a supercomputer - you need Serif Health.
If you’re paying attention to healthcare news, you probably saw the recent posting in Fierce Healthcare about a report from Georgetown University stating that “many of the data files are far too large to access without help from a supercomputer.”We’re happy to report that simply is not accurate. You don’t need a supercomputer, you just need Serif Health. We’ve custom engineered a data pipeline to work with and extract data from the most complex payer files in the country quickly and cost-effectively, and our extractor can run on any hardware - even a laptop.
Matthew Robben · FEB 2, 2023 
MRFs
5 min read
UnitedHealthcare's Massive Walkback on Transparency in Coverage Data
This month, Serif Health digs deeper into UnitedHealthcare's MRF files posted since last August. While UHC 'complies' with the price transparency rules with their postings, UnitedHealthcare is systematically reducing the data in those postings, and for a common use case, 70% fewer prices can be located in their files than were accessible in August. This reduction in data volume means in-network providers' rates can no longer be located in the MRF, and this is happening in every nationwide network file posted by UHC. If these data reductions continue, UHC TiC postings will become effectively useless. Read on for more!
Matthew Robben · FEB 27, 2023 Start with your first question
You bring the question. We'll bring the signal.