Usual, Customary, and Reasonable Data the Right Way
The Healthcare Pricing Challenge
In today’s complex healthcare environment, insurance companies, employer groups, and other healthcare organizations need defensible, comprehensive, and up-to-date fee data in order to re-price claims. Ensuring that the right service is administered at the right cost is a cornerstone of proper healthcare coverage. However, with one doctor billing a service at $100, and another doctor right next door billing the same service at $800, how can a payer know what are usual, customary, or reasonable fees?
UCR Database from the Source
We have been a leader in UCR (usual, customary, reasonable) fee analysis for almost 30 years. Using a proven statistical methodology, we analyze billions of provider charges to ensure that payers have the most defensible fee information available. According to Oxford Outcomes, our data sourcing “is more likely to provide representative data compared to other common sources of fee data” and that “provider billing/charge data is an appropriate basis for UCR benchmarking.”
Need localized UCR fees? Click here for Physician Fee Reports!
No Surprise Billing Compliant
Developed and refined by our team of data scientists, our methodology ensures that the UCR fee products represent current provider charges from around the country without payer adjudication adjustments. Our UCR data offerings are fully compliant with federal No Surprises Act regulations concerning national databases. You can use the best UCR analysis in the industry with no concerns about regulatory issues.
Included UCR Database Modules
Medical fee data across every provider specialty, with fees for both Global and Professional service components.
Anesthesia fee data for services rendered by anesthesiologists as well as by other providers under the anesthesiologist’s direction.
Outpatient Facility data made up of hundreds of millions of charges. The outpatient facility setting is the dominant location for medical and surgical procedures.
Dental fees for all service types such as diagnostic, preventative, restorative, endodontics, and all the rest.
HCPCS code fees covering thousands of common services not covered through a CPT code.
Inpatient Facility fees based on CMS MEDPAR data, allowing you to accurately price each day of the hospital stay, or the entire stay, by each DRG code.
Since 1994, Context4 Healthcare has been the industry’s trusted source for defensible, dependable, and accepted UCR data.
Hundreds of payers nationwide use it to calculate their plan liabilities. Shouldn’t you? Click below now to see the Context difference today!
