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LIVE · CMS TRANSPARENCY IN COVERAGE

Stop guessing what healthcare actually costs.

Cove Lane Health turns 500+ terabytes of CMS and commercial pricing data into real-time, Confidence-Scored benchmarks. Defensible in any room.

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Drop a real screenshot here.

Data indexed

500 TB

Query type

Live · never cached

Modules

9 integrated

——— THE PROBLEM

Pricing data is public. Almost none of it is usable.

500 terabytes published. Still mostly unusable.

Healthcare pricing is complex. The volume required to answer a straightforward question is daunting — files are cumbersome, fragmented, and spread across innumerable formats. Most teams still benchmark with a quarterly PDF and a spreadsheet of guesses.

Renewal meetings get decided on stale comparables. Audits get written around best-effort sources. The data has been public since 2022 — almost no one is using it.

——— CAPABILITIES

What you can do with Cove Lane Health.

Four primitives. Composable through the UI or the API. Every output ships with a Confidence Score and a source trace — no separate "audit mode".

CLAIMS REPRICING

↗

Drop a file. Get a defensible savings analysis in minutes.

Upload historic claims or generate representative ones. Line-by-line repricing against current market percentiles. PDF, Excel, or API.

MEDIAN RETURN · 240MS

LIVE BENCHMARKS

↗

Any code. Any market. Any percentile. Returned in milliseconds.

Stack markets side-by-side. Save the query, share the link.

P25 · P50 · P75 · CUSTOM

CONFIDENCE SCORE

↗

Every number arrives with its receipt.

A 0–100 match-quality score, surfaced on every output. Inspect the source trace. Defend the methodology when the room gets harder.

0–100 · SOURCE-TRACED

NETWORK & API

↗

Wire it in.

NPI-EIN mapping. No-claims simulation. Signed exports. Versioned REST API. Tenant-isolated keys. Webhook delivery.

REST · WEBHOOK · SIGNED

——— HOW IT WORKS

From file to defensible report in three minutes

One pipeline, four steps. No configuration calls, no implementation projects. Drop a file or hit the API; the output is on your desk before the next meeting.

01 · UPLOAD

Drop a file or query

837/EDI, CSV, or direct API call.

CSV File · 1,247 lines · 3.2 MB

02 · MATCH

Real-time engine

Live query against current rates by NPI, code, geography.

240ms · 1,247 of 1,247 matched

03 · SCORE

Confidence breakdown

Every line gets a 0–100 score and a source trace.

median 91 · range 78–96

04 · EXPORT

Audit-ready output

PDF for the binder, Excel with formulas, API for the platform.

Formatted Tables · 12 pages

——— WHO IT'S FOR

What buyers tell us they were missing.

Defensible at renewal — percentile-grounded benchmarks, not a quarterly PDF.

BENEFITS LEADERS

SELF-FUNDED EMPLOYERS

Faster than the cycle — a live query returns what used to take weeks.

CONSULTANT TEAMS

TPAS & ADVISORS

Audit-ready by design — built around CMS rules, not retrofitted.

COMPLIANCE OFFICERS

HEALTH PLANS & CARRIERS

Differentiated advice — show clients market truth before they ask.

BROKERAGE PRINCIPALS

MID-MARKET BROKERS

DEFENSIBILITY

Built for the rooms where numbers get challenged.

SOURCE TRACE · SHA-PINNED SNAPSHOT · INSPECTABLE METHODOLOGY

The renewal meeting where the carrier pushes back. The compliance audit. The CFO asking where the number came from. Cove Lane outputs are built for those rooms — when the question gets harder, you don't get smaller. You reach for the export, hand over the source, and the conversation moves on.

——— METHODOLOGY

The number is only as good as what backs it

Live data, scored at the source.

Cove Lane queries CMS Transparency in Coverage publications and licensed commercial files directly — no quarterly caches, no third-hand summaries. Every percentile carries a Cove Lane Confidence Score: a 0–100 measure of match quality, computed live alongside the rate. Inspectable, exportable, traceable to the publishing entity and date.

——— COMMON QUESTIONS