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At OpenCareData we make healthcare Transparency in Coverage data useful. We convert obtuse machine-readable files into actionable data. Try it right now, below.

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Unlock the complete suite of filters and features by subscribing. Our demonstration mode is set to search the BCBS Texas dataset using MSA 26420, encompassing Houston, Sugar Land, and Baytown, Texas.

Specify your specialty's taxonomy code(s) to ensure accurate rates. Not doing so may result in considerably lower rates for providers who may never perform the procedure.

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How it Works

Using federally mandated machine readable file (MRF) data provided by commercial insurance providers, OpenCareData harvests and processes these files so that with a simple search, you can see median and average payments for any medical charge within your geographic location.

Aquire Data

We download and keep a copy of every machine readable file.

Data Extraction

Our proprietary software extracts all information from the json files and creates searchable silos of data.

OpenCareData

We merge several outside data sources to produce clear and actionable views of the data.

View the guide on Guru

What Can You Do With OpenCareData

Use OpenCareData to calculate qualifying payment amounts (QPA) according to CMS requirements.

Obtain median in-network and average rates to help facilitate insurance claims appeals and no surprises act (NSA) federal independent dispute resolutions (IDR).

Negotiate insurance contracts with your actual competitors names and contracted rates in hand. Blue Cross offering you $900 for a 99285 yet offering a provider 3 miles away triple? Now you know.

Perform market research before you place your new clinic or institutional facility by seeing all contracted providers in any geozip or msa with their full names and actual contracted rates for each service they provide.

Develop and defend damage models in lawsuits with insurance carrier’s own data

Already using GoRev to manage your practice and revenue cycle? OpenCareData can be integrated to show you live comparisons at the claim level. Not using GoRev? You should be! Check it out here!

CONTRACTED RATES

GEOZIPs & MSAs

ALL BILLING CODES

This is BIG Data

One of the main challenges of big data is the sheer volume of information being generated. With so much data to sift through, it can be difficult to identify meaningful insights and trends. Additionally, healthcare data is often complex and unstructured, requiring sophisticated algorithms and analytical tools to effectively analyze.

We are working hard to bring you clean, accurate, and insightful data... and more payers are being loaded every day!

Our Current Datasources

Source	States
AETNA Pro Inst	All States
Anthem-CA-CO-CT-GA-IN-KY-ME-MO-NV-NH-NY-OH-VI-WI Pro Inst
BCBS Arkansas Pro Inst	Arkansas
BCBS Florida Pro Inst	Florida
BCBS Idaho Pro Inst	Idaho
BCBS Illinois Pro Inst	Illinois
BCBS Louisiana Pro Inst	Lousiana
BCBS CareFirst Coming Soon!
BCBS Michigan Pro Inst	Michigan
BCBS Minnesota Pro Inst	Minnesota
BCBS Montana Pro Inst	Montana
BCBS North Carolina Pro Inst	North Carolina
BCBS Nebraska Pro Inst	Nebraska
BCBS New Mexico Pro Inst	New Mexico
BCBS Oklahoma Pro Inst	Oklahoma
BCBS Texas Pro Inst	Texas
CIGNA Pro Inst
Kaiser Permanente Pro Inst	All States
Optum Pro Inst	All States
UHC Pro Inst	All States

Clear Pricing Makes It Easy

How many MSAs do you need? MSAs are unlimited after the first 15

All Geozips found within an MSA are provided as filter options as part of your licensed MSAs.

Click here to learn about MSAs Sign up!

Use this handy slider to calculate your MSA needs!

Grab me!

Monthly

$ 250 per month

3 Additional Users

Selected MSAs

Unlimited searching

Access to all filters

20% discount

Annual

$ 2400.0 per year

3 Additional Users

Selected MSAs

Unlimited searching

Access to all filters

20% discount

What is an MSA? What is a geozip?

CMS's guidelines requires your MSA for calculating QPA. If you are unsure about
what MSA you are in, use our simple MSA Lookup Tool to locate.

MSA Lookup Tool

MSA is the acronym for Metropolitan Statistical Area. The MSA is the formal definition of a region that consists of a city and surrounding communities that are linked by social and economic factors. MSA’s are 5-digit codes of 306 high population-density geographic areas that are delineated by the U.S. Office of Management & Budget.

MSA are used for a variety of purposes for collecting, tabulating, and publishing federal statistics. It is an economically and socially integrated unit consisting of one or more contiguous counties (or statistically equivalent areas) containing at least one city of a population of 50,000 or more, and a metropolitan population of 100,000 or more (75,000 in New England).

A Geozip is the first 3 digits of a zipcode. For example, the geozip of 78642 is 786. All Geozips found within an MSA are provided as filter options as part of your licensed MSAs.

OpenCareData Security

SOC 2: GoRev, OpenCareData's parent company, uses an independent third party to conduct a SOC 2 audit. This audit covers the SOC 2 Common Criteria and the Confidentiality and Privacy trust services criteria. We’re happy to share this report with clients or prospects with a signed non-disclosure agreement on file.

Opencaredata.com performs regular penetration testing and vulnerability scanning through the use of third parties and internal scanning solutions.

Data encryption in transit via TLS1.2
Multi factor authentication
Granular role based permission management
Annual penetration testing is performed by a third party
Vulnerability scanning is performed regularly by a third party
SOC 2 / HITRUST certified Data Center

About Us

Founded in 2014, Venture Development has been at the forefront of healthcare, optimizing revenue cycle management processes thru the development of cutting-edge software solutions. A long-time mainstay in the field of emergency medicine, its flagship software offering, GoRev, is also widely used in acute care hospitals and ambulatory surgical centers. In 2020, Venture expanded its services platform and developed a full LIMS system capable of supporting high complexity laboratories.

OpenCareData.com is our latest product to take to market. Passionate in our pursuit to bring more transparency and truth to the American healthcare marketplace, our system is capable of converting millions of healthcare pricing records into real, actionable data. Knowledge is power and thanks to the Transparency in Coverage requirements, providers and patients alike are able to harness this meaningful healthcare data for the first time in history. As the paradigm shifts, we’re proud to have a hand in bringing about much needed change through OpenCareData.

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