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OpenPayer (by Trek Health) — A normalized, continuously monitored corpus of US commercial payer policy — the machine-readable replacement for payers' scattered PDF policy libraries. Scale as published by the vendor: 150,000+ commercial health plan policies, 45,000+ policy documents across 100+ to 150+ commercial payers, indexed against 22,000 billing codes, 200+ service lines and 150+ payer profiles. Each policy is classified by payer, type (Clinical, Reimbursement, Administrative), specialty (Pharmacy & Specialty Drugs, DME, Orthopedics/Musculoskeletal, Infectious Disease and others), change…
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A normalized, continuously monitored corpus of US commercial payer policy — the machine-readable replacement for payers' scattered PDF policy libraries. Scale as published by the vendor: 150,000+ commercial health plan policies, 45,000+ policy documents across 100+ to 150+ commercial payers, indexed against 22,000 billing codes, 200+ service lines and 150+ payer profiles. Each policy is classified by payer, type (Clinical, Reimbursement, Administrative), specialty (Pharmacy & Specialty Drugs, DME, Orthopedics/Musculoskeletal, Infectious Disease and others), change type (New or Modified) and effective date, with AI-driven ingestion, validation and normalization and continuous change detection with watchlists and alerts. Because the parent platform also ingests and normalizes Transparency in Coverage machine-readable files and hospital price transparency data quarterly across 120+ payers, 50M+ insurance rate records and 6,000+ facilities, the policy corpus can be joined to negotiated-rate and contract intelligence — the pairing of what a payer's coverage rule is with what the payer actually pays for the service, which is close to unobtainable as a combined dataset.
Scale 150Coverage Financials · Health CareAsset class Equities
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OpenPayer (by Trek Health) — A normalized, continuously monitored corpus of US commercial payer policy — the machine-readable replacement for payers' scattered PDF policy libraries. Scale as published by the vendor: 150,000+ commercial health plan policies, 45,000+ policy documents across 100+ to 150+ commercial payers, indexed against 22,000 billing codes, 200+ service lines and 150+ payer profiles. Each policy is classified by payer, type (Clinical, Reimbursement, Administrative), specialty (Pharmacy & Specialty Drugs, DME, Orthopedics/Musculoskeletal, Infectious Disease and others), change…
Openpayer offers (Alternative, Reference, Price, Fundamental) — 150,000+ commercial health plan policies; 45,000+ policy documents standardized across 100+ to 150+ commercial payers; 22,000 billing codes indexed; 200+ service lines; 150+ payer profiles. Adjacent parent-platform corpora add 50M+ insurance rate records from machine-readable files and price data for 6,000+ hospitals, refreshed quarterly. Each policy record also stores the normalized structured representation alongside the cited source document, so the raw-plus-derived text corpus is larger than the record count..
Denial prediction and prior-authorization automation grounded in current payer criteria; revenue-cycle and reimbursement teams' contract evaluation and underpayment detection, especially where policy data is joined to the parent platform's negotiated-rate corpus; payer contract negotiation with policy and rate evidence together; provider-side policy-impact modeling, quantifying revenue exposure when a payer modifies a coverage rule; utilization-management and clinical-criteria benchmarking across payers; pharma and specialty-pharmacy market access, tracking when payers add step-therapy or coverage criteria to specialty drug products; health-policy research on how coverage criteria propagate across commercial payers over time; and as supervision data, the document-to-structured-record pairs (raw payer PDF to classified policy with codes and effective date) are a high-value training set for regulatory and clinical document-extraction language models, arguably the most reusable asset in the corpus for an AI buyer.
Coverage spans US; Managed Care, Health Care Technology; alternative, reference, price, fundamental; equities.
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