Seasons greetings from Serif Health!
In the spirit of closing out the year strong, we are excited to announce our latest product suite with exciting new offerings for employers, benefits consultants, and TPAs.
For the last several quarters, we have been working with several partners on an end-to-end toolkit for self-funded plans to significantly reduce their costs and meet 2024 Transparency in Coverage (TiC) compliance requirements. As part of the Serif platform, we have built and shipped:
Cost estimation and care navigation solutions:
- Cost estimates: Use the Serif Health rates API to power cost estimation within employee search portals as part of the TiC compliance requirements for January 2024 where plans and TPAs must be able to display out-of-pocket cost estimates for members for any given medical procedure. For those looking for fast turnaround or new solutions partners, we have implemented successful upgrades to existing cost estimator engines and effectively integrated into customer portals in a matter of weeks.
- Network tiering and utilization management: Generate preferred provider lists from scanning the price transparency data to identify lowest cost providers for given services. Cross-compare easily to quality data from several of our partners like HealthCorum to determine where to steer employees for their care.
Claims auditing and re-pricing:
- Payment integrity and verification: With Serif automated reports, you can quickly compare claims remittances to machine readable file (MRF) fee schedule data for specific provider NPI code-level line items to identify overpayments.
- Network analysis: Claims-to-MRF comparison can also help accurately simulate the cost of care across selecting various networks and carriers. Use Serif’s network analytics tools as decision support for which networks will save the most costs for your population’s care needs.
Direct contracting:
Easily fill adequacy gaps and keep employees in-network by using Serif’s price transparency data to prospect low-cost, high-quality providers to add to your network. Once you identify candidate providers to contract with, easily see their rates with other comparable self-funded plans and fully-insured payers to determine a fair rate structure.
Snowflake and Databricks Marketplace Access:
Across all the above use cases, Serif continues to provide flexible formats to ingest and work with the price transparency data from dashboards to .csv reports to bulk parquet data. Recently, we expanded our distribution to the Databricks and Snowflake marketplaces for those looking to house MRF extracts directly inside their data warehouse. We are excited to keep building for Databricks and Snowflake customers.
Serif Health in the News:
Serif Health co-founder and CEO, Rafiq Ahmed, was recently the featured guest on the podcast Building Better Businesses in ABA Therapy. If you are interested in learning more, give it a listen to hear him discuss the nuances of price transparency regulations and the now available machine readable file data to share how healthcare providers and organizations can utilize price transparency data to improve their market knowledge and power better pricing and reimbursement strategies.
If you are interested in reaching out or have any questions, please feel free to email sales@serifhealth.com or book time directly here. We love brainstorming, hearing folks’ feedback, and seeing how we can help.
Hope you enjoy, and happy holidays from Serif Health!
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