FAIR Health Delivers “Custom Cut” Benchmark Products
September 19, 2024
FAIR Health’s vast repository of commercial medical and dental claims has many applications. Our widely used FH® Benchmark products give stakeholders the tools they need to explore and understand the healthcare system. In addition to filling the need for stakeholders that are interested in the full sets of benchmarks, there are some stakeholders that wish to explore specific subsets of the data in our benchmarks. FAIR Health routinely fulfills many “custom cut” requests of this nature.
Our custom cut products include tailored cuts of non-discounted amounts charged by providers (FH® Charge Benchmarks) and amounts allowed for reimbursement by payors (FH® Allowed Benchmarks). These products represent professional claims for medical, surgical, dental, anesthesia and telehealth services, as well as inpatient, outpatient and ambulatory surgery center facility claims, among others.
For a custom cut request, stakeholders may seek a subset of the data provided in a standard benchmark product. They may request benchmark data for specific procedure codes or for a specific geographic area, or a combination of both. They may also request the data in a variety of formats that suit their end needs or make the data easier to access, for example, fixed width, delimited files, text or Excel files, or any combination of these.
A typical example of a custom cut request could include a client who seeks benchmark charge costs for behavioral health services received via telehealth. The client may therefore request a cut of our FH® Charge Telehealth benchmark product that includes only those CPT®1 and HCPCS codes for professional services related to behavioral health.
Alternatively, a client may wish to focus a data inquiry on specific geographic areas—for example, New York and New Jersey—and request benchmark charge and/or allowed data for only those states.
FAIR Health provides custom cuts such as these to a range of healthcare stakeholders, including payors, consultants, billing services, facilities and life science organizations. Other interested stakeholders include healthcare providers, academic researchers/institutions and government entities.
Stakeholders use our custom cut products in many ways. Common applications include fee schedule management; bill review; claims adjudication; arbitration, mediation and litigation; plan, benefit and provider network design; market research; and analysis projects.
FAIR Health President Robin Gelburd stated: “FH Benchmark products have become the industry-standard claims data resource, but they can also be useful starting points for stakeholders seeking to home in on data that are even more specific to their needs. Custom cut requests allow FAIR Health to deliver a flexible variety of specialized benchmark products with data presented at the granular level that best fulfills stakeholder needs.”
Find out more about the benchmark products we offer here.
For more information on FAIR Health’s data repository and our custom cut products, contact us by email at info@fairhealth.org or call us at 855-301-FAIR (3247), Monday through Friday, 9 am to 6 pm ET.
1 CPT © 2023 American Medical Association (AMA). All rights reserved.