Pricing Transparency

Understanding payer coverage and patient burden

DESCRIPTION

Populi’s Pricing Transparency API allows you to see how payments for procedures in your network compare with local, state and national trends. By comparing both 835 and 837 claims Populi enables you to see financial metrics for both initial claims and adjustments after remittance. See the average, minimum, maximum, or total amount of both charges and adjustments for any procedure or service line of interest. Financial metrics can also be compared across different types of insurance coverage.

Key Features

Claims and Remits

Analyze comparisons of 837 and 835 data to distinguish claims vs remits allowing users to view the real delta between what was requested vs what was actually paid.

Charge Detail

View min, max, average and total charges for the selected procedure codes or groupers on all remits returned in your query.

Patient Burden

Transparent views on patient co-pay allow you to understand what the min, max, average and total patient burden for the selected services are.

Adjustments and Plan Contributions

View min, max, average and totals for allowed and adjusted amounts to see plan contributions across the selected procedures.

Accessing the Product

Populi API gives you complete control over how, when and what you want to build.

price transparency api code

Related Solutions & Products

Network Management

Populi’s network management solutions include analytics products that look at provider volumes, provider performance, reimbursement insights and referral patterns.

Procedural Analytics
Strategic Planning

Providing Strategic Planning departments with volume, benchmark and forecast insights on patients, consumers and providers to assess competitive market share, demand, utilization and predictive trends.

Populi for Tableau

Populi’s for Tableau gives you instant access and flexibility to build your own views and dashboards on all of the Populi products.

Procedure Volume

Populi’s Procedure Volume API allows you to query the total number of procedures for each Provider. The data is segmented by year and month to enable tracking of trends over time.

HCx Directory

Populi’s HCx Directory allows you to retrieve the best-in-class profiles with the most up-to-date data on Providers address, contact and personal information.

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