How does Serif change the price transparency data?

Serif adds value to the price transparency data in several ways:

• We trim outlier rates based on review of actually billed amounts from claims data

• We add provider detail information such as location, taxonomy, name from our proprietary provider directory

• We filter out “ghost rates” and “zombie rates” based on review of utilization data (e.g., dermatologist rates for a knee surgery code)

• We add in relevant CMS / Medicare baselines to each row of data where applicable

• We cross-walk abnormal code types (e.g., CSTM codes, LOCAL codes) to actual CPT, RC, DRG codes. Read more here: https://help.serifhealth.com/article/41-custom-code-crosswalking

• We standardize rates that have inconsistent formulas across payers. See our anesthesia example here: https://help.serifhealth.com/article/42-anesthesia-rate-scaling