Openpayer

OPENPAYERbuyer room · privateManage buyer room

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.