Data iSight Methodology

The most defensible, transparent way to value non-contracted medical claims
Two businessmen looking at computer and report wearing shirt and ties

Why Data iSight is the right choice for healthcare payers

H3 green dash

Launched in 2007, the Data iSight methodology was developed out of a need for healthcare payers to have a means to reprice non-contracted charges – fairly and effectively. Trusted by over 100 payers*, Data iSight is patented and validated by statisticians as effective and fair all while delivering deep savings on non-contracted claims with wide provider acceptance.  By applying national benchmarking, regional wage indexing and geographic adjustment among other methods, it allows for the optimal reimbursement compared to Usual and Customary and Medicare-Based pricing.

The right choice for healthcare payers

H3 green dash

Learn from our experts about how the Data iSight methodology helps payers save on claims where a contract is not available.  Watch to learn more.

Accepted

H3 green dash

Data iSight is accepted by providers 94% of the time and 97% of the time by facilities, making it a defensible methodology for payers. The results are repeatable and consistent, and they also address common provider objections to Medicare or charge-based methods.

Flexible

H3 green dash

Data iSight may be used by self-insured and insured plans and may be configured to apply only to specific claim types, with or without negotiation on appeal, and with or without patient advocacy. It may be supported in plan documents as a benefit limit, or used as a cost management strategy.

Transparent

H3 green dash

Data iSight’s high acceptance rate is aided by online transparency for all audiences: payers, providers and plan members. Each may log into our online portal and uniformly review how reductions were calculated, thereby lessening appeals.

A better reference for pricing

H3 green dash

There is a growing trend among healthcare payers to base reimbursement for non-contracted claims on Medicare reimbursement rates, under the name of Reference-Based Pricing. The problem is, Medicare is not only a flawed valuation for many healthcare services, but it also can deliver unintended consequences. The better measure is one that more directly ties to a provider’s own costs.

Smiling business woman with glasses looking at computer

Strike a balance

H3 green dash

Is your pricing strategy for non-contracted claims too aggressive or too conservative? Maximize savings and minimize balance-billing with fair reimbursement.

To learn more, visit our contact us page and let us know you’d like to learn about our Analytics-based services.

*Per Q1 2019 reported internal data.