Data iSight^®

A fair, transparent solution providing consistent, widely accepted reimbursement recommendations for out-of-network claims.

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Fair Reimbursement

Defensible Methodology

Supportable reference-based pricing with high provider acceptance.

Out-of-network spending is growing at a rate far surpassing in-network spending. With its supportable, industry tested methodology and consistent, transparent recommendations with same-day turnaround on over 98% of claims, Data iSight can help you manage out-of-network costs — and has done so for over 100 healthcare payer clients.

Making our IMPACT Clear

$48B

Saved in Last 10 Years

5.4M

Reduced Claims

90–96%

Provider Acceptance

Data iSight is an alternative to U&C or Medicare-based reimbursement recommendations for out-of-network charges. Using publicly available claims data and a proprietary benchmarking process, Data iSight calculates fair reimbursement that is generally cost-based for facilities and based amounts that are generally accepted for providers.

Recommendations are consistent and widely accepted by providers, and the integrated appeal management solution can take the burden off you while helping to limit balance billing.

Flexibility and transparency that create value.

By applying national benchmarking, regional wage indexing, and geographic adjustment among other methods, Data iSight delivers fair, transparent reimbursement recommendations.

Strategize

Data iSight can be used as a comprehensive cost containment program for both fully-insured and self-insured plans, or as the benefit limit is defined in plan documents.

Configure

Your cost containment needs may evolve. Data iSight is a configurable solution that balances cost savings with member satisfaction, helping to maintain scalability and efficiency.

Protect Members

Appeal handling options are available if providers initially disagree with Data iSight’s reimbursement recommendation.

Support

With more than 15 years of experience in claims, we understand the importance of member and provider transparency and support, which is why we have integrated appeal management options.

Engaging insights.

New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.

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