Give members clarity before care, not after the bill

For Payers & TPAs

Why Shopping for Payers & TPAs?

Satisfy Transparency in Coverage requirements with a member shopping tool or ongoing MRF creation — and put the same benchmark data to work across QPA support, IDR disputes, and out-of-network negotiations.

• TiC-compliant member shopping tool customized by plan type and personalized for members.
• MRF creation & hosting — In-Network, Out-of-Network (Allowed Amount), and Table of Contents files for network components without pre-existing MRFs: wrap networks, direct contracts, and the one-off In-Network files required for hospital plans with domestic Tier 1 networks.
• Care Navigation support using benchmark negotiated rates across payers, procedures, and providers.
• No Surprises Act support — market-based reference rates to support Qualifying Payment Amount (QPA) determination and evidence for the Independent Dispute Resolution (IDR) process.
• Out-of-network negotiations & repricing — anchor OON offers and reprice claims against current contracted market rates.
• Provider disruption and adequacy, plus tiered-network what-if modeling, run from the same census you already uploaded.