The intelligence layer for American healthcare rates

Ghost Rate Report

Counts, live, how many rows in a payer's published transparency file fail verification and never reach a provider. See how real a payer's data actually is.

Medicare Rate Engine

Decode any CPT and ZIP to the locality-correct Medicare rate, model a whole fee schedule at a target multiple, and score your codes against Medicare and the local peers. The clean baseline every rate is measured against.

Leverage Clock

The negotiation calendar. Shows when the window to renegotiate a payer contract actually opens, so you move on leverage instead of missing it.

Medicare State League

Every state ranked by how well Medicare pays for a service. The league table that shows where the country is generous and where it is thin.

Code Reality Check

Pick any CPT. Its real commercial median in every state, next to Medicare, and how far the same code swings across the country. The tool all 113 code pages open into.

Exclusion Check

Check any NPI against the HHS OIG federal exclusion list (LEIE) — the parties barred from federal health programs. Exact-NPI match only, from the public file. Table stakes for credentialing and buy-side diligence.

Core Database

Every rate line a practice holds, one row per code, payer and modifier, against the local peer median and the top-of-market target. Filter on every axis, sort every column, export the sheet.

The fast one they live in. 82 real rate lines where the old sheet showed 26 codes and only each code's best payer, so the second payer, the one you actually negotiate, was invisible.

New Business Finder

Search any dental practice in the federal registry by market, specialty, code and ZIP. See which ones bill medical codes, which ones we already hold contracted rates for, and open any of them in the Core Database.

Dentistry is Medicare-excluded, so a dental practice carrying Medicare-observed dollars is billing MEDICAL codes. That is the qualifying signal for a medical-billing company, and it is measured, not inferred.

DME Spread Finder

Medicare DME pay by code and area, sorted by the widest high-to-low spread.

Spot the margin that's quietly leaking out of a supplier's book in seconds.

Renewal Almanac

A free calendar of every payer's ACA individual and small-group rate-filing window, by the month it recurs each year.

Never walk into a renewal cold again. The whole market's timing on one page.

Honest Peer Standard

Resolve any NPI to its correct specialty and true peer group, so a benchmark is finally apples-to-apples.

The quiet fix that makes every rate comparison honest. The standard everyone else will cite.

Packet Studio

The negotiation packet itself, computed for a real NPI: the practice's own contracted rates against the published Medicare locality schedule, its position against the local peer cohort where one exists, and one defensible ask. Every figure is deterministic SQL from the payers' own federal filings, and the peer basis is stated on the row.

It shows its work, including the exhibit that refuses to print a number and prints the query that returned zero instead. The model writes the argument; it never writes the arithmetic.

Negotiation Playbook

One practice, one payer, one situation: the ordered steps to work it, the evidence under each step, what the payer is most likely to say back, and the answer. Built on the negotiation precedent corpus and the live doctrine store, with the state's own statutes attached.

It prints what it REFUSED to use. Choosing the situation resolves which remedy is being argued, the lanes we are not arguing are named and counted rather than silently filtered, and every prohibition the evidence carries is shown to the operator. It ships on mechanism and statute and says so, because no published case exists of a dental practice winning a documented commercial increase off transparency data.

Renewal Board

Every practice in your book, ranked by which payer window opens next. Filter by state, payer, specialty or ZIP, save a search, and export the board. Undated contracts are shown as their own segment, never dropped and never guessed.

The only tool here that answers for a whole book at once. For a billing company the question is never "which of my 40 practices" but "which one first", and this is the surface that answers it.

Renewal Concierge

A done-for-you renewal packet, timed to your window: your rates, the local-peer median, and the counter, ready to send.

Turns "we should renegotiate" into a packet on the rep's desk. Renewal season, handled.

Practice Revenue X-Ray

Your documented opportunity, weighted by the volume you actually bill, not a flat per-code guess.

The audit that shows real dollars where they really are. Modeled, never guaranteed.

IDR Outcomes

A practice's own record at federal No Surprises Act arbitration, two ways: by code (each payer and CPT, how often it prevailed and how far above the payer's QPA the winning offer landed, plus a modeled prevailing dollar) and by payer (your payers ranked by market softness, softest to fight first). Real CMS Federal IDR data.

The full arbitration picture for one NPI: which fights you win, and which payer to take on next.

Downcode Radar

Detects systematic per-payer downcoding and ranks the dollars, with the appeal argument attached.

Catches the quietest leak in the book and hands you the fight already written.

Recoupment Radar (Edit Exposure)

Your federal NCCI edit exposure two ways: My billed book scans the codes you actually bill for the PTP pairs recouped without the rescuing modifier and the strict daily MUE ceilings; Paste a day scrubs a single day's code set on-device for bundling edits, MPPR reductions, and modifier gaps before you submit. The clawback-defense checklist, with the federal rationale and modifier verdict on every pair.

Stops the recoupments before they happen, whether you scan your whole book or a single claim. Straight from CMS's own edit tables.

835 Workbench

Drop your remittances: every underpayment, downcode, denial and DMEPOS cut in one ledger, read from what the payer actually paid. Parsed on your device; no patient field is ever stored or sent.

The proof layer under the whole platform. Every other tool reasons about what a payer SHOULD pay; this one carries what they DID, so an underpayment stops being an argument and becomes a document.

Dental Rate X-Ray

One NPI in: the practice's reimbursement anatomy on one sheet — the medical (CPT) rates payers publish but dentists never see, the dental (CDT) peer market, the Medicaid floor multiple, and every medical pathway you could be billing dental, with a 300-850 RateScore and three separately-labeled totals.

The first time a dental or oral-surgery practice sees its own market. The medical-dental rate arbitrage no competitor can copy without a decade of medical-MRF infrastructure — the dental vertical flagship.

Dual-Bill Router

For oral surgery: real, cited CDT↔CPT medical-necessity crosswalks (trauma, pathology, TMJ, OSA, implant reconstruction) with the real local-market rate on each side and the documentation checklist each path needs.

No dental billing software automates this decision today — real research, zero incumbents found.

Appeal Leverage Engine

For dental/OMS denials: a known, cited downcode pattern check, the plan-type classification that routes to the escalation lever with actual jurisdiction (ERISA claims-file demand vs external review vs peer-to-peer), and real statutory late-payment interest for independently-verified states.

Routes the fight to the lever that actually has jurisdiction, and puts a real statutory-interest dollar figure in the letter — nobody else does either.

Transition Signals

The succession-supply map from real CMS graduation years: which specialties and states hold the most late-career providers, and therefore the most practices heading toward a sale or wind-down. Plus any NPI's public career-stage facts and a modeled transition indicator.

Pitch Engine

Co-branded, data-backed pitch decks a billing firm or MSO can send a prospect in one click: RateScore, documented opportunity to the local-peer P90 target, and an AI talk track.

Rate Diligence Room

A hash-sealed buy-side room that answers one question for an acquirer: is this target's revenue durable, or riding above-market rates that compress on renewal? Real prices vs the local-peer median, the renewal calendar, and the modeled dollar-at-risk.

Rate-level diligence no bank can run. The room PE will pay to sit in.

Denial Index

Which ACA marketplace plans deny the most in-network claims and overturn the fewest appeals, ranked from CMS's own published numbers, by state. Plus the appeal playbook by denial code.

CMS's own figures, named and ranked, with the fight already written for each denial code.

IDR Win Report

The federal No Surprises Act arbitration scoreboard, from real CMS data: providers win ~86% of disputes, and the winning offer lands near 4x the payer's own QPA. By specialty, state, code, and payer, plus any provider's own IDR track record.

RateScore Inside (API)

Embed RateScore in your own software. One call in, a scored, benchmarked rate out.

Our engine inside everyone else's product. The quiet anchor line of the business.