Powering the best health plans
Pay less for healthcare, stop fraud, waste and abuse, and deliver a better member experience with My Price Health!
Proudly serving these and other innovative healthcare companies
Trusted, open, and powerful tools to fix healthcare
RBP and Contract Pricing
Lower costs with accurate and defensible Medicare and contract pricing
Fraud, Waste & Abuse Reduction
We follow national clinical rules to reduce unnecessary costs
Open Data Platform
No vendor lock-in, and your data is always yours
HIPAA Compliant
Security and Privacy are top priority to ensure your data is always secure
Faster Response
Our API response times are measured in milliseconds for real-time results
Secure Web API
Build your application with the METL data platform through secure APIs
Your data is always yours! We bring back the Portability and Accountability in HIPAA
Some companies rely on fear, uncertainty, and doubt to cloud HIPAA rules. They paint the picture that they are hoarding healthcare data for our own good. In reality, they hoard data to make more money and hide their double-dealing. We make data access easy and give you freedom to decide how you want your data used and shared.
A community-built open source data platform for unrivaled innovation and security
The world’s security protocols are open source. It enables trust and many eyes to spot problems. We believe the best way to build a new healthcare system is together. The METL platform enables access to all payer-focused data for better coordination and convenience. Partner companies can save millions in implementation costs vs. building their own or renting a 3rd-party solution.
Accurate Medicare pricing for your claims
Ask three different pricing vendors for the Medicare price on a claim and you’ll probably get three very different answers. We don’t guess whether we’ve got it right, we use the same rules as the Medicare Administrative Contractors (MACs) do, and we test against millions of Medicare claims to ensure we’re pricing the same as the MACs. We currently have less than 0.4% pricing difference and 1.4% pricing variance compared to the MACs (*as measured against CMS Limited Dataset pricing) and continue to improve our accuracy each release.
Easy and powerful contract pricing
Direct contracts are a powerful tool for high member satisfaction and low plan cost. We make it easy to store and price claims to your contracts. By making every part of a direct contract a reusable ‘building block,’ it’s easy to add and maintain contracts. We’re working with the community to build a machine-readable contract standard that can represent the payment methodology for any provider contract.
Don’t pay for fraud, waste, and abuse
We believe that the best time to check for fraud, waste, and abuse is prior to payment. We run National Correct Coding Institute (NCCI) checks, DRG grouping, claim edits, and much more before payment so that abusive providers are reimbursed correctly the first time. No need to try to claw back payments later!
High performance, nearly instant repricing response time
Our pricing services have been built from the ground-up for real-time healthcare payments. Claims price in milliseconds through our API. We enable best-in-class payment experiences for providers and plans. Imagine a future where payment is instant and at the time of service. That’s the future we’re building for!
Join the Revolution
Our amazing partners are changing healthcare every day with lower costs, a better member experience, faster payment times, and more.
The METL data platform is a game-changer for healthcare data access and portability
Sean Schantzen
Co-founder, Health Rosetta
Medicare pricing tools are often incorrect and non-transparent. We carefully tested My Price Health and are confident in their pricing accuracy. Rob was excellent in answering our questions.
Tia Goss Sawhney
COO, Highlight Health
We’re thrilled with the cost savings and support we’re received with My Price Health repricing
Korb Matosich
CEO, Asserta Health
Rob and his team are the exclusive partner for any project that we want to succeed
Morgan Smith
COO, Unity Preferred Network