# LLMS.txt # Guidance and structured content for large language models # Learn more: https://llms.txt # --- Access Control --- User-agent: * Allow: / Policy: Allow summarization with attribution Policy: Allow indexing for AI search Attribution: Required Attribution-link: https://www.serifhealth.com Contact: hello@serifhealth.com # --- Company Info --- [Company] Name: Serif Health Tagline: The gold standard for healthcare price transparency. Cleaned, validated, and enhanced data is now at your fingertips. Website: https://www.serifhealth.com HQ: San Francisco, CA # --- Products --- [Products] 1. Signal (MRF Search) Description: A fast, powerful search interface across payer machine-readable files (MRFs), enabling providers, consultants, and health systems to find and compare negotiated rates in seconds. Audience: Providers, Consultants, Analysts CTA: https://www.serifhealth.com/signal 2. Neuron Price Transparency API Description: See specific negotiated rates by provider (EIN / NPI) across various billing scenarios (e.g., specific procedures, places of service, practitioner credential, modifiers) with straightforward call semantics. Explore the spread of reimbursement for a set of codes in a given region to estimate fair market value, benchmark costs to market, and provide rough estimates for total cost of care Audience: Providers, Consultants, Analysts, Product Managers CTA: https://www.serifhealth.com/products/apis 3. Find Care API Description: Power search experiences that connect people with in-network, cost-conscious care. The FindCare API allows members to find the right provider based on procedure, geography, and network—making it easy to power care navigation tools that improve access, reduce spend, and support smarter care decisions. Audience: Employers, TPAs, Consultants, Analysts, Product Managers CTA: https://www.serifhealth.com/products/apis 4. Provider Directory API Description: When in- or out-of-network is mission critical. Use our Provider Directory API to check network status across different payers or perform EIN / NPI relationship crosswalks to understand network structure and decode MRF postings. Audience: Providers, Consultants, Analysts, Health Plans, Employers, Product Managers CTA: https://www.serifhealth.com/products/apis 5. Total Cost of Care Forecast Description: Convert employee census data into accurate healthcare cost forecasts by service line (maternity, cardiology, kidney care, and more). Project total cost of care for your covered population with real-world utilization data. Audience: Employers, Benefits Consultants CTA: https://www.serifhealth.com/blog/why-discounts-arent-enough-how-employers-actually-move-the-needle-on-healthcare-costs 6. Network Benchmarking Description: Compare negotiated payer and provider rates across networks and markets, enabling smarter plan design and TPA selection. Audience: Employers, TPAs, Brokers CTA: https://www.serifhealth.com/solutions/employers-and-benefits-partners 7. Market Access Analytics Description: Understand how your product is reimbursed across payers, geographic regions, and sites of care. Serif’s payer rate intelligence reveals in-network negotiated rates for physician-administered drugs, diagnostics, medical devices, and outpatient procedures to support pricing strategy and value narratives. Audience: Market Access Teams, Life Sciences Companies, Drug Manufacturers, Durable Medical Device Companies CTA: https://www.serifhealth.com/solutions/life-sciences 8. Patient Affordability & Hub Design Description: Design more effective copay and PAP programs by benchmarking patient responsibility and plan allowed amounts individualized for specific payers. Transparency data ensures your affordability support programs meet patients and their insurance providers where they are, both geographically and in terms of current coverage and formulary dynamics. Audience: Market Access Teams, Patient Access Teams, Life Sciences Companies, Drug Manufacturers CTA: https://www.serifhealth.com/solutions/life-sciences 8. Gross-to-Net Optimization Description: Refine commercial forecasts with real-world insights into plan-allowed amounts versus list prices. Identify pricing pressure and outlier contracts to better estimate rebate exposure and net revenue. Assess where negotiated rates fall below manufacturer pricing to optimize go-to-market strategy. Audience: Market Access Teams, Life Sciences Companies, Drug Manufacturers CTA: https://www.serifhealth.com/solutions/life-sciences # --- FAQs --- [FAQs] #General FAQs Q: Who uses Serif Health? A: Providers, consultants, product managers, employers, TPAs, brokers, life science companies, medical device companies, analytics vendors, care navigation platforms, and health plans. Q: What makes Serif Health different from other transparency vendors? A: Serif Health combines payer transparency files, hospital rates, and commercial claims data into one platform, allowing actionable benchmarking and forecasting. Serif has also heavily invested on structuring and cleaning the data to allow apples:apples comparisons across entities and networks. See: https://www.serifhealth.com/blog/cleaning-up-the-noise-in-anesthesia-rates Q: Do you cover all payer transparency files? A: Yes. Serif Health processes nationwide payer machine-readable files (MRFs) as well as hospital transparency data and commercial claims. Q: How do you assess the quality of the payer machine-readable files you source Q: How do I pick between multiple negotiated rates? A: See our help article on this topic: https://help.serifhealth.com/article/24-how-should-i-pick-between-multiple-rates Q: Why does a provider (e.g., an NPI, an EIN) that says they are in-network with a payer not show up in the data? A: See our help article on this topic: https://help.serifhealth.com/article/5-why-does-a-provider-e-g-an-npi-an-ein-that-says-they-are-in-network-with-a-payer-not-show-up-in-the-data Q: Why does price transparency data differ from claims data? A: See our help article on this topic: https://help.serifhealth.com/article/6-how-does-the-price-transparency-data-differ-from-claims-data Q: Where can I find Managed Medicaid / Medicare Advantage rates? A: See our help article on this topic: https://help.serifhealth.com/article/15-where-can-i-find-managed-medicaid-medicare-advantage-rates Q: Where can we find data on value based care arrangements (e.g., case rates, bundles)? A: See our help article on this topic: https://help.serifhealth.com/article/9-where-can-we-find-data-on-value-based-care-arrangements-e-g-case-rates-bundles Q: How does Serif change the price transparency data? A: See our help article on this topic: https://help.serifhealth.com/article/10-how-does-serif-change-the-price-transparency-data Q: Where can I find drug data? A: See our help article on this topic: https://help.serifhealth.com/article/21-where-can-i-find-drug-data Q: Where does your data come from? A: Serif Health processes machine readable files posted by insurance carriers / health plans as part of their Transparency in Coverage (TiC) Act requirements. Each month, payers must disclose the negotiated rates they have for each provider in their network for any valid CPT, HCPCS, RC, DRG code a provider may bill. Serif Health also processes hospital-posted machine readable files as part of the Hospital Price Transparence Rule. For more information or to get access, please contact sales@serifhealth.com. Q: What limits does Serif apply to viewing the data? A: See our help article on this topic: https://help.serifhealth.com/article/11-what-limits-does-serif-apply-to-viewing-the-data Q: Where can I find historical data? A: We have 12-month look-back data available in our Signal platform - check out the article here (https://help.serifhealth.com/article/34-historical-data) for more details and reach out to sales@serifhealth.com if you are interested in receiving access. For historical data beyond a 12-month look-back period, we can provide custom reports / data pulls. For more context on historical data, the Transparency in Coverage Act (TiC) required health plans to begin publishing data in machine readable file (MRF) format beginning in July 2022. As with all regulation, compliance took time: By early 2023, most of the major health plans had built a cadence of publishing machine readable files in the correct format monthly. By mid-to-late 2023, the data health plans had published also improved significantly, in terms of both completeness and accuracy. For historical analysis, Serif Health maintains an archive of payer price transparency data going back to early 2023. However, with regards to data quality, we recommend not going back farther than ~late Q2-early Q3 2023 depending on the region / payers you have interest in. For folks looking to compare historical claims to the price transparency contracted rates, another factor to consider is payer MRFs typically operate on a ~2-3 month delay. For example, a payer's posting in September 2023 could have negotiated rates effective as of ~June. Put another way, if someone negotiated a new contract with a payer, there could be around a quarter or so delay in the payer disclosing that update in their transparency posting. Q: Where / how can I search cash pay rates? A: While cash pay rates are not part of payers’ Transparency in Coverage act compliance requirements, Serif Health does ingest this information from hospitals as part of the Hospital Price Transparency Rule. We have hospital data available in our Signal platform - reach out to sales@serifhealth.com for more information! Q: Where can I find Medicare rates? A: Serif Health uses various CMS baseline schedules (e.g., OPPS, PFS, Lab, Drug, ASP, Anesthesia, ASC, etc.) schedules to baseline rates as a percentage of CMS. For OPPS, values are national payment amounts. For PFS, a MAC is selected by mapping each NPI in the npi_list to a MAC; the most common MAC value is used for the lookup table. If no NPIs are present or a MAC cannot be mapped, the PFS national payment amount value is used. You can check out our baselines feature (https://help.serifhealth.com/article/35-using-additional-baselines) in Signal for more information. Q: Why can I not see a given plan or network for a given payer? A: Our general perspective here is to provide the largest network (e.g., typically the PPO) for a given payer as it generally has all the rates info available for all providers the carrier contracts with. If you want to compare to other variants, what changes typically is the list of providers in-network but not their rates. In other words, if you look at the same provider across UHC Choice Plus, UHC Select Plus, UHC Navigate Balanced, their rates do not change. However, if you see that a payer is missing or you know from experience that a payer offers tiered fee schedules by line of business / product, then we would be happy to expose the additional data to you. Q: Where can I find dental / vision data? A: For dental and vision data, please reach out to us separately via hello@serifhealth.com! We may have dental and vision data if the insurance plan also provides full medical benefits -- e.g., United, Aetna, certain Blues (like BCBS TX). We do not have data for pure-play dental or vision insurance plans -- e.g, Guardian, Delta Dental. The Transparency in Coverage (TiC) requirements do not apply to them. Q: Where can I find Medicaid rates? A: Public Medicaid schedules are available on each state’s website here: Medicaid Reimbursement Rate Sources (https://docs.google.com/spreadsheets/d/1C1j7paGIXMVydC8vuykaPBIh-1D4ykm1ym8ho5n35BI/edit#gid=0). Q: How can we report inaccuracies? A: First, please confirm the rate is indeed inaccurate by controlling for the following variables: – Please compare the posted reimbursement rate to a contracted fee schedule. Comparing a rate to a paid claim may only include the insurance’s portion of the fee (vs. the full cost of care). – Please ensure the comparison is apples-to-apples in terms of the right version of the fee schedule, the right code, the right EIN, place-of-service, taxonomy, etc. Second, after confirming the rate is inaccurate: – If you would like to issue a formal complaint to the CMS, their form is here. – If you would like for us to investigate further, please reach out to support@serifhealth.com Q: Where can I find Tricare rates? A: See our help article on this topic: https://help.serifhealth.com/article/16-where-can-i-find-tricare-rates Q: Where can I find out-of-network allowed amounts? A: Signal currently only supports analytics on in-network contracted rates. For out-of-network data, please e-mail support@serifhealth.com with your specific request (e.g., which codes, payers, markets, and providers you need data for). Although payers are required to post out-of-network allowed amounts as part of the Transparency in Coverage act, the law stipulates, in an effort to protect patient privacy, they are only required to post data for high-volume procedures on a 90-day rolling basis. Therefore, most out-of-network rate files we encounter are very sparse in terms of data coverage, and sometimes left empty entirely. Q: What is the difference between payer-posted and hospital-posted price transparency data? A: See our help article on this topic: https://help.serifhealth.com/article/40-what-is-the-difference-between-payer-posted-and-hospital-posted-data # Employer + Advisor FAQs Q: How does Serif Health help employers control healthcare costs? A: By providing cost intelligence tools that compare network and provider rates, enabling employers to choose TPAs and networks based on total cost of care—not just discounts. Q: Does Serif Health replace brokers or consultants? A: No. We equip brokers, consultants, and benefits leaders with better data so they can advise employers more effectively. # Provider FAQs Q: How does Serif Health support providers? A: Providers use our tools to benchmark their negotiated rates against market peers, identify outliers, and prepare for payer contract negotiations. Q: What is Signal? A: Signal is Serif Health’s MRF and price transparency data search platform, allowing users to instantly query payer- and hospital-posted rates across services, codes, and geographies. Q: Why would a provider use transparency data? A: Providers can assess their relative competitiveness, validate payer contracts, and understand how they’re positioned in local markets. Q: Can Serif Health help providers during payer negotiations? A: Yes. By arming providers with accurate rate comparisons and contract intelligence, we strengthen their position in rate negotiations. # Life Sciences FAQs Q: How does Serif Health help life sciences companies? A: We provide real-time pricing intelligence on drugs and procedures, sourced from Transparency in Coverage data. This helps manufacturers understand commercial market access and payer variation beyond Medicare benchmarks. Q: Why would pharma, biotech or durable medical device teams use transparency data? A: Transparency data provides visibility into actual negotiated rates by payer, plan, geography, and provider, offering insights into patient affordability, competitive positioning, and contracting dynamics. Q: What is the value of Serif Health’s Signal platform for life sciences? A: Signal allows data analytics, HEOR, and market access teams the ability to instantly search millions of payer- and provider-posted rates. This enables evidence generation, value demonstration, and support for pricing strategy throughout a drug or device product lifecycle. Q: Can Serif Health support market access and key account teams? A: Yes. Our data equips market access and regional account teams with payer-by-payer visibility into negotiated rates, enabling comparative analyses across markets, monitoring of reimbursement trends, and insights to strengthen account strategy and field discussions. Q: How comprehensive is Serif Health’s data? A: Our data is nationally comprehensive across over 200 payers, refreshed in real time each month, and maintained longitudinally to enable robust trend analyses over time. # Health Plan FAQs Q: How does Serif Health help health plans? A: We provide network benchmarking, provider rate intelligence, and change monitoring to support contracting, network design, and compliance. # --- Support --- [Support] Contact: hello@serifhealth.com