Payorology offers a specialty‑focused portal that aggregates Transparency in Coverage rate data and verifies it against a practice’s actual payments to the penny. The platform provides analytics on reimbursement gaps and expert consulting to help independent and multi‑location medical practices negotiate fee‑for‑service contracts with data‑backed confidence.
Funding
Funding not disclosed
Founders
Product
Problem
Medical practices lack reliable, specialty‑specific price‑transparency data needed to negotiate payor contracts, leading to asymmetric negotiations and hidden reimbursement gaps.
Solution
Payorology creates a curated, specialty‑focused portal that aggregates publicly required Transparency in Coverage rate data and verifies each benchmark against the practice’s actual remittances down to the penny. The platform presents vetted rates alongside specialty‑specific analytics and provides expert guidance to interpret the data, develop negotiation strategies, and identify reimbursement shortfalls. By acting as an external price‑transparency department, Payorology enables practices to renegotiate contracts with data‑backed confidence, supporting revenue growth and improved patient care.
Target Audience
Primary customers are independent medical practices and multi‑location provider groups that negotiate fee‑for‑service contracts with health insurers and seek data‑driven leverage in those negotiations.
Features
- Specialty‑specific portal that consolidates all CPT code rates published under the Transparency in Coverage rule
- Automated verification of benchmark rates against the practice’s actual payment data for exact penny‑level accuracy
- Integrated analytics that highlight reimbursement gaps and comparable market rates
- Expert consulting team available to contextualize data, answer complex questions, and shape live negotiation tactics
- Support for custom research projects such as M&A analysis, market expansion, and partnership assessments
- Secure, cloud‑based access with regular monthly updates of payor rate data