Our Data
Payer Transparency Data
Each month, Serif Health ingests 200+ commercial payers' in-network machine readable file (MRF) disclosures across their core fully-insured, self-insured, and exchange lines of business.
200+
Commercial payers
500+
PPOs, HMOs, ASOs and Exchange Plans
350+ billion
Rates processed monthly
Refreshed monthly since 2023
Step One
Ingestion
Each month, Serif Health ingests 200+ commercial payers' in-network machine readable file (MRF) disclosures across their core fully-insured, self-insured, and exchange lines of business. This translates to 500+ networks spanning PPOs, HMOs, ASOs, exchange plans, rental networks, and behavioral health networks, encompassing roughly 90%+ of commercial lives covered in the US.
A month's worth of data contains 350+ billion rows detailing each provider's in-network negotiated rates across all codes available in their fee schedule. We have historical data going back to early 2023. To augment the payer releases, we also use nationwide hospital price transparency, PBM, CMS, and commercial claims data.
Explore Sample DataStep Two
Quality Assurance
Once ingested, Serif Health normalizes and cleans the data to eliminate the noise. We screen and filter out clinically unbillable or 'zombie rates' by utilizing nationwide commercial claims data to track what codes various providers actually bill in practice. This means you will not see a dentist show up with a knee surgery rate, just because the payer included that procedure code on that dentist's fee schedule.
Explore Sample DataStep Three
Enrichment
After cleaning the data, we add several fields to make the data powerful for your use cases, including provider details (e.g., name, address) both at the group EIN and NPI level, a provider's specialty, and CMS reference rates so you can benchmark rates as a percent of Medicare.
We also enable our customers to analyze historical price transparency data and trends back to January 2023. Our full schema is available here:
See what our customers are saying
Serif’s tools have unlocked key pieces of information that have supported how we structure our contracts. They’ve been a helpful partner in understanding price transparency data, and their team has consistently gone above and beyond to quickly source data to assist with our needs.
Serif's reimbursement data has been instrumental in informing which clinical groups are viable for us to work with. After zeroing in on those groups, it has allowed us to shortcut the arduous back and forth of gathering reimbursement pricing data from them, something that is particularly difficult when helping a clinical group expand their service offerings. Being able to show up at an early stage meeting with reimbursement information in hand and in a deck has been a game changer and wins us significant credibility right off the bat.
Using the data from Serif has been incredibly helpful for our payor negotiations. There is no longer a mystery about where you stand in the market.
Signal makes complex MRF data easy to use. Other tools we looked at returned significantly more 'junk' data and clutter that made us do extra work. As a multispecialty provider with several surgery centers, Serif equalizes the knowledge disparity between payers and providers.
Powering healthcare price transparency for over 300 companies – from startups to enterprises.
Sample Data
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