UCR Done Right
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 is a payer to know what’s usual, customary, or reasonable?
UCR Data Straight from the Source
We have been a leader in UCR (usual, customary, reasonable) fee analysis for over 25 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."
Developed and refined by our team of fee experts and 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 tailored to fit the needs of your organization, segmented by percentile with over 340 distinct geo-zip regions.
Included UCR Database Modules
Medical fee data across every provider specialty, with fees for both Global and Professional service components.
Dental fees for all service types such as diagnostic, preventative, restorative, endodontics, and all the rest.
Anesthesia fee data for services rendered by anesthesiologists as well as by other providers under the anesthesiologist’s direction.
HCPCS code fees covering thousands of common services not covered through a CPT code.
Outpatient Facility data made up of hundreds of millions of charges. The outpatient facility setting is the dominant location for medical and surgical procedures.
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, Context 4 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?