Frequently Asked Questions

You'll see actual contracted rates or allowed amounts by selected cpt code that practices in your area receive from each insurance company. For example, if your contract rate with Aetna is $58, you might discover competitors are getting a contracted rate of $68. Or by selected cpt code, if you're getting $150 per office visit from Aetna, you might discover competitors are getting $180-200 for the same service. You'll know exactly where you rank - are you in the bottom 25% or top 25% of rates in your market?

Most practices are flying blind. You might think your $165 per visit is "pretty good" until you see that three practices within adjacent counties are getting $195-220. Our data shows you instantly whether you're underpaid, fairly paid, or getting premium rates compared to your direct competitors.

You're actually taking a bigger risk by NOT knowing market rates. Insurance companies count on providers accepting below-market rates out of fear. And the longer your relationship with your insurance company's representatives, the more they benefit. Knowledge protects you - ignorance makes you vulnerable to continued underpayment.

Yes, and you should. Waiting until renewal means negotiating from weakness. Start gathering intelligence now so you can approach renewals with confidence and market data, not desperation. With a low setup fee, you will continue to receive actionable real-time rate updates.

Perfect - that's actually when this data is most powerful. In small markets, you can see every competitor's rates and know exactly what the insurance company is paying others. You might discover you're the lowest-paid practice in town, or that you have room to negotiate much higher rates. If your rates are similar, comparison with practices in adjacent counties or a state-level view can identify a benchmark rate.

Not at all. No IT setup, no training required. You log in, select your specialty and county, and immediately see competitor rates organized in easy-to-read charts and summary tables. Think of it like checking your bank account online - simple, instant, clear information.

Knowledge is leverage. Instead of asking "Can you do better?" you can say "I see that practices similar to mine in this market are receiving $195 per visit for this service, and you're offering me $165. Let's discuss bringing my rates in line with market standards." Suddenly you're negotiating from strength, not hope. Each chart/graph/analysis offer negotiating strategies

Then you'll have peace of mind and confidence in your current contracts. Plus, you'll know which payors (payor parity analysis) value your services appropriately and which ones you might want to prioritize for growth.

You'll have the exact data you need to request rate reviews with your payors. Instead of hoping for the best, you can present market evidence showing what fair compensation looks like in your area. We offer a negotion guide to our users that suggest best strategies.

They'll never tell you - that information gives you negotiating power they don't want you to have. You will hear about revealing rates violates non-disclosure in agreements. This is why they fight transparency so hard in court. Our service gives you the intelligence they won't share.

Generic online averages are useless for negotiations. We show you actual contract rates for competitive practices in your and selected counties by taxonomy. It's the difference between knowing "doctors somewhere make around $X" versus "doctors in my specialty within these counties for payor Aetna makes exactly $185 per visit." Specific practice names and their rates are available.

Dramatically. Practices across the street from each other often have 20-40% rate differences for identical services. Loyalty doesn't guarantee fair compensation - market intelligence does.

Start preparing now. Most contracts allow for rate discussions during the term, and you'll be ready with market data when renewal time comes. Plus, you'll see rate changes happening in real-time, so you'll know when market rates increase and can time your negotiations accordingly.

Solo practices often benefit most because you don't have the negotiating power of large groups. This levels the playing field by giving you the same market intelligence that health systems use. You'll negotiate like an informed business owner instead of hoping for the best. We've been told by small single or two provider practices that this information can save samall practices in America.

Completely different. Those consultants show you regional averages or percentile ranges - useful but generic. We show you that Dr. Martinez at Valley Medical gets $247 per 99213 from Anthem while Pacific Group gets $198 for the same code. You see actual contracted rates, not statistical summaries. It's the difference between knowing "the average house price in your neighborhood" versus knowing exactly what each house sold for.

Because we're using the same TIC machine-readable files that your payors use internally for their own analytics. When Anthem builds their provider cost reports or Aetna analyzes network spend, they're using this exact data. We're not estimating or surveying - we're processing their actual reported contracted rates. The data quality is enterprise-grade because it IS enterprise data.

We show actual practice names linked to their rates. While other services anonymize everything, we've solved the technical challenge of connecting TIC data to real provider identities. You'll see "Riverside Family Medicine: $185/99213/Aetna" not "Anonymous Provider #847: $185." This makes the intelligence actionable instead of academic.

Dramatically. Instead of walking into negotiations saying "we think our rates are below market," you walk in with "we know that comparable groups in this market are receiving 15-23% higher rates for these specific services, and here's the data." Health plans can't bluff about "market standards" when you have their actual contracted rates with your competitors sitting on the table.

Let's be conservative. If this data helps you negotiate just $5 more per encounter across your providers, and you average 300 encounters per provider monthly, that's $270,000 annually in additional revenue for a $1,500 investment. Most groups we work with identify significantly larger gaps - practices discovering they're 15-25% below market rates on their high-volume codes.

Consulting engagements typically run $25,000-50,000 annually and provide periodic analysis. Our service gives you the same intelligence continuously for under $2,000, updated monthly. Plus, consultants often rely on the same TIC data we provide - you're essentially cutting out the middleman and getting direct access to the source intelligence.

Yes - our PowerRate Intelligence tracks renewal patterns, contract effective dates, and rate change timing. You'll see when competitors' contracts renew, allowing you to time your negotiations strategically. If three major practices just renewed with 15% increases, you know the market has moved and can negotiate accordingly.

Absolutely. We use federally mandated TIC MRF data that insurance companies are required by law to provide. The Oregon lawsuit involves different state-level requirements.

Insurance companies are suing because rate transparency threatens their "competitive business advantage" - their own words in court filings.

No. You're accessing federally mandated public data that insurance companies are required by law to provide. They cannot retaliate against you for using information they're legally obligated to make available. It's like being penalized for reading the newspaper.

No. You're accessing publicly available, federally mandated data. Insurance companies cannot retaliate for using information they're legally required to provide.

This is individual market research, just like any other business intelligence. Every industry analyzes competitor pricing - from gas stations to restaurants to retail stores. Healthcare has been the exception, and that's finally changing.

All data is de-identified public information (no patient data involved), hosted on enterprise-grade secure servers with standard healthcare industry security protocols. Since we're working with publicly available TIC data rather than PHI, HIPAA requirements don't apply, but we maintain healthcare-industry security standards regardless.

Extremely accurate. We use the same TIC MRF data that insurance companies use internally. This isn't estimated data - these are actual contracted rates, updated monthly.

Raw TIC files contain billions of unorganized records requiring IT teams and months of analysis. Enterprise solutions cost $50,000+ and still require technical expertise.

We convert complex data into actual contract rates organized by your taxonomy and county. You get answers, not data dumps.

We cover all medical specialties and every county in the United States. Whether you're family practice in rural Montana or cardiology in downtown Chicago, we have the rate data for your market and specialty.

Monthly, following the federal requirement. Insurance companies must update their rate files monthly, and we process those updates to give you the most current market intelligence available.

Extremely granular. You can see rates for specific CPT codes, by individual providers, by location, by contract effective dates. If Dr. Johnson has different rates at his main office versus his satellite location, you'll see both. If a practice has tiered rates based on volume, you'll see the actual rate structures, not just averages.

Our county-based system is perfect for rural areas. You can see rates in your county plus adjacent counties to understand your broader market.

Minimal. If your team can use Excel and navigate basic web interfaces, they can use our platform effectively. The complexity is in our data processing and analytics - your interface is designed for healthcare executives, not data scientists. Most practice managers are productive within their first session.

Because our founder is a practice manager who understands real practice budgets. Enterprise solutions charge $50,000+ because they're built for health systems, not independent practices.

If our intelligence helps you negotiate even $5 more per office visit, you'll recover your investment in weeks. Consider: if you're getting $150 per visit and competitors get $180, that's $30 per visit lost. See 100 patients monthly? That's $36,000 annually.

Most practices see ROI within weeks. If you're currently getting $150 per visit and discover competitors get $180, that's $30 per visit in lost revenue. See 100 patients monthly? That's $36,000 annually you're leaving on the table. Our service costs under $1,500 - you only need to negotiate a few dollars more per visit to recover the investment.

Immediately. Once you select your taxonomy and counties, you'll instantly see competitor rates in your market. No waiting, no setup time, no technical implementation.

Yes, we offer sample data demos so you can see exactly what you'll get before purchasing. You'll see real rates from real practices in a sample market to understand the value.

No long-term contracts. You pay a setup fee to access your selected counties/specialties, then a low annual renewal fee. No monthly fees, no hidden costs, no premium tiers with missing features.

Easy to expand. You can add more county/specialty combinations anytime. The platform grows with your practice needs without requiring a complete restart or losing your historical data.

Yes, your package includes multiple user access so your contracting committee, administrator, and key physicians can all have access. Everyone works with the same current data, but you can customize views and alerts based on individual roles and interests.