Frequently Asked Questions
A. Reveon Health offers several quarterly subscriptions for different health insurance reimbursement rate data - each subscription tied to a major insurance company, such as United Healthcare (UHC), Anthem (BCBS), and Cigna. The subscription grants you unlimited access to view that insurance company's rate data, allowing you to generate reports that you can use to easily see contracted rates for common CPT codes, compare with others in your area, and make informed decisions about joining a clinically integrated network.
Please contact us through our Contact Us page. Provide us with specific information about your practice, your provider NPI, state/region, specialty, and anything else relevant to your interests. We will send you a sample report to demonstrate why Reveon is one of the most essential medical provider resources available today.
The website gives a few output examples from a Reveon Health report. You can also Sign Up to see a free demonstration video. Within the app, you are able to search for NPIs or EINs, find provider groups in your area, view and compare contracted reimbursement rate data for common CPTs for a variety of specialties, search for provider groups with better CPT rates, and view detailed specialty information about those provider groups to make better informed decisions about healthcare contract management, negotiating rates, and verifying and auditing your own realized reimbursement rates against insurance company data.
Once you subscribe, you have immediate access to the Reveon Health Portal, which allows you to generate your own reports. Reports can include NPI and EIN lookups to find provider groups near you, comparison of CPT codes payment rates between different provider groups, specialty breakdowns of EINs and provider groups, and more. Each report loads in seconds. You can export the reports to an image or CSV file within the app for use in your contract negotiations. See our Terms of Service for more details on use.
As long as you adhere to the terms in the Terms of Service, there is no limit on your access to data granted to you by your current active subscriptions.
Sharing of login information is not allowed by our Terms of Service. Our goal is to provide you and your colleagues with a product so affordable that everyone can access it - not just hospitals and large corporations. If you find the data and analysis insightful, we do encourage you to share this fact with your colleagues and motivate them into signing up for Reveon Health as well!
Access to a web browser is all that is required. Our servers do all the processing. For best viewing, we recommend using a computer or tablet with support of at least Full HD (1080p) resolution. The app does not display well on lower-resolution, small screens, like phones.
Hospitals and insurance companies are required to post and update this data monthly by regulations passed by the Transparency in Coverage Executive Order into machine-readable-files (MRFs) that are publicly available. These files are not user-friendly and require intense data processing and analysis to find diamonds in the sand. Reveon Health does this analysis for you and presents the results through an affordable subscription model.
Each insurance company and hospital is required to post health insurance reimbursement rate data every month to be compliant with requirements of Transparency in Coverage. This data is available on each of their websites. We aggregate data from major entities, including as examples, United Healthcare and Anthem (BCBS).
We strive to keep our processed data archives as up to date as possible and will do our best to regularly update our data and ensure all reports are no older than two months. Within each report that you generate, the data archive will tell you the "valid date" that it was created and posted by the insurance company, so you will be informed of the relevancy of every report. If a data file shows that it is more than two months old, we are either working on updating it, or the insurance company has not updated it recently (which does occasionally happen).
Transparency in Coverage (TiC) was an Executive Order issued in 2019 and finalized in 2020 that required health insurance providers and hospitals to publish machine-readable files (MRFs) containing in-network negotiated rates and out-of-network allowed amounts and billed charges. These MRFs are very large, are not standardized, use inconsistent schema, and require significant parsing and data analysis to find useful data products. The rollout of various features required by TiC took place over the forthcoming years and are still evolving.
Yes, in fact, this data is required to be posted by TiC. Lack of transparency in medical and insurance pricing has been a substantial problem in the United States and one of the leading contributors to increased overall costs to patients and unfair reimbursement to providers. Further exacerbating the problem, many insurers will put clauses in contracts with providers and provider networks that prevent providers from disclosing their proprietary contract rates with others, leading these providers to question whether access to this data made available by TiC is allowable. You can both adhere to the terms of your contract and access this publicly available information.
JavaScript Object Notation (JSON) files are structured data files that can flexibly store data and pass information between applications. They are commonly used in web applications because they can easily parameterize the data in a way that both humans and machines can visualize and understand it. They do not work effectively with storing large databases, however, and in the case of the machine readable files (MRFs) provided as a result of TiC, they result in extremely large, fragmented, poorly documented datasets that require substantial analysis to find and generate useful data reports.
In the context of TiC, MRFs are the files posted by insurance companies and hospitals to be compliant with terms of TiC requiring disclosure of negotiated rates. These files are huge - sometimes over 250 GB each - because they use the JSON format, which is not a data-efficient storage mechanism. There are hundreds or thousands of these files for every insurance company, and lack of specific required standards from TiC rules means that the quality of the data in these files is inconsistent.
A clinically integrated network (CIN) is a group of healthcare providers, including hospitals and independent physicians, that collaborates to improve the quality and efficiency of patient care. These networks work together to standardize treatment protocols, share best practices, and use data to improve outcomes while reducing costs. Providers often share certain data and records to accurately track results and measure improvements.
CINs can leverage a large network of providers to succeed in medical insurance contract negotiation as a group, achieving generally better reimbursement rate outcomes for their providers than a provider would be able to achieve on his or her own. CINs often require sharing of data and implementation of common best practices and shared vision, leading to a reduction in autonomous decision making, however. Reveon Health provides you access to rate data so you can make better informed decisions when evaluating CIN options.
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