PRICE TRANSPARENCY

Simplify compliance and bring clarity to healthcare pricing

ElevatePFS Price Transparency helps health systems meet complex CMS requirements while simplifying the creation of accurate, publish-ready pricing data. Our turnkey solution automates compliant files that include chargemaster pricing, payer-specific negotiated rates, and detailed shoppable services.

By structuring complex data into clear, standardized outputs, organizations can maintain compliance with confidence while improving transparency for patients and stakeholders. Files include billing codes or HCPCS identifiers, payer rates, de-identified minimum and maximum pricing, and bundled service logic for shoppable procedures.

 

We work all accounts specified by the provider at an agreed-upon frequency. Our team immediately begins identifying reasons for claim denial or rejection and following up to obtain documentation for billing or re-billing. We track Medicaid, Medicare, and commercial health insurance coverage and billing deadlines, and all claims are prioritized according to timely filing deadlines, write-offs, patient transfers, and potential for collecting.

As a value-added service, our proprietary screening software scrubs all accounts with no identified health insurance coverage against commercial and government payer databases to locate coverage that may have been available at the time of service. When coverage is identified, we then bill the appropriate payer or Medicaid program and collect on behalf of the hospital.

The Elevated Difference

1

A fully turnkey approach simplifies complex CMS requirements by automating the creation of compliant, publish-ready files that include chargemaster pricing, payer-specific negotiated rates, and detailed shoppable service data.

2

Rapid implementation with no software installation reduces operational burden, enabling teams to quickly establish and maintain compliant pricing workflows without disrupting existing systems.

3

Expert support ensures accuracy and completeness, guiding organizations through validation, customization, and ongoing updates to maintain compliance and strengthen trust with patients and stakeholders.

4

Flexible data structuring allows organizations to align transparency outputs with internal strategies, ensuring pricing information is clear, consistent, and tailored to meet regulatory and patient-facing needs.

A Partner You Can Trust
for Unmatched Results.

ElevatePFS® delivers outstanding results. With more than 2,500 client facilities and a 95% client retention rate, we’re a proven partner that you can count on.

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