01
Scope
Ask for the slice the analysis needs.
Define the relevant payer, provider, market, and billing-code criteria instead of processing every record in every file.
On-Demand TiC Data
Transparency in Coverage data, without the 100GB headache
Define the payer, provider, code, and market data you need. Lumivera extracts, structures, validates, and delivers a focused dataset through a self-serve interface, Excel, or API.
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What is Transparency in Coverage data?
Transparency in Coverage data is payer-published pricing information for covered healthcare items and services. The machine-readable files can expose negotiated rates, but they are built for publication—not for the analyst trying to answer a provider, payer, code, or market question.
Lumivera's On-Demand TiC Data product lets teams define the slice they need, then extracts, structures, validates, and delivers a usable dataset without requiring them to process the raw files themselves.
On-demand TiC extractillustrative
payer-rates.json104 GB · raw
Extract→Clean→Validate
rates.xlsx2.1 MB · usable
Provider resolved
Codes normalized
Outliers reviewed
DeliveryUI · Excel · API
Move from raw publication files to a dataset your analysts can use
The federal rule makes pricing information available. It does not make every file small, consistent, comparable, or ready for a provider contracting question.
| Today | With Lumivera | |
|---|---|---|
| Starting point | Large payer machine-readable files | A focused payer, provider, code, and market request |
| File structure | Nested records and inconsistent fields | Normalized fields built for filtering and analysis |
| Record quality | Duplicates, incomplete rows, and implausible rates mixed together | Unusable and non-comparable records separated from the output |
| Provider context | Identifiers require additional resolution | Relevant provider and market context attached to the extract |
| Traceability | Analyst must reconstruct where each result came from | Source and inclusion context retained with the data |
| Delivery | Build and maintain a custom processing pipeline | Configure in the UI, export to Excel, or pull through API |
From source file to usable rate data
Scope the question. Extract the records. Validate the rates. Deliver the output.
02
Extract
Resolve the relevant payer-published records.
Pull the requested pricing evidence from the source files and map it into a consistent structure.
03
Validate
Separate usable evidence from noise.
Review duplicates, incomplete records, implausible values, and comparability while preserving source context.
04
Deliver
Put the output into the analyst workflow.
Use the focused data in Lumivera, export it to Excel, or pull it through an API for downstream analysis.
Data quality and traceability
Published does not automatically mean analysis-ready
Payer files can be large, inconsistent, and difficult to compare. Lumivera structures the requested data while retaining the source context needed for defensible analysis.
Regulatory context: CMS Transparency in Coverage.
01
Resolve the source
Retain the payer, file, plan, provider, code, and publication context behind the extracted record.
02
Normalize the structure
Map inconsistent file structures and identifiers into fields analysts can filter, compare, and export.
03
Remove unusable records
Separate duplicate, incomplete, implausible, or non-comparable rates from the evidence your team will analyze.
04
Keep the logic traceable
Preserve enough source context to understand what a rate represents and why it was included in the output.
TiC data designed for provider questions—not raw-file archaeology
Reduce the data-engineering burden while keeping the pricing evidence focused, usable, and traceable.
Configure a focused extract
Start with the payer, provider, market, and code criteria tied to the analysis question.
Normalize complex structures
Map the requested records into consistent fields analysts can filter and compare.
Remove unusable noise
Separate duplicate, incomplete, implausible, and non-comparable records from the output.
Resolve relevant context
Keep payer, provider, plan, code, and market context attached to the extracted evidence.
Preserve traceability
Retain enough source and inclusion logic to explain what each result represents.
Deliver data your team can use
Move from a self-serve query to Excel or API without building the raw-file pipeline first.
Use the data where the work happens
From focused query to usable output
Start in Lumivera, hand a clean file to an analyst, or connect the output to an existing workflow.
Configure in the UI
Define the payer, provider, code, and market slice you need without writing a raw-file processing pipeline.
Export to Excel
Download a focused dataset for analyst review, market comparisons, fee-schedule work, or internal modeling.
Pull through the API
Bring structured rate data into the workflows and analysis environments your team already uses.
Common questions
On-Demand TiC Data, explained
What is Transparency in Coverage data?
Transparency in Coverage data is pricing information published by most group health plans and health insurance issuers under federal requirements. The files can include negotiated pricing for covered healthcare items and services and can be used by third parties for analysis.
Why are payer machine-readable files difficult to use?
The files can be extremely large and structurally complex. Analysts still need to identify the relevant payer, provider, plan, code, and rate records; normalize inconsistent fields; remove unusable records; and retain enough source context to interpret the result.
What can I request with On-Demand TiC Data?
The product is designed for focused payer, provider, market, and billing-code questions. Teams configure the slice they need rather than downloading and processing an entire raw payer file for every analysis.
How does Lumivera validate TiC data?
Lumivera structures the requested records, resolves relevant identifiers and context, and separates duplicate, incomplete, implausible, or non-comparable rates from the output. The source context is retained so analysts can understand what a rate represents.
How is the extracted data delivered?
Teams can configure the request through a self-serve interface, export a focused dataset to Excel, or pull structured rate data through an API for use in existing workflows.
What can provider teams do with TiC data?
Provider teams can use structured TiC data for payer rate benchmarking, managed care negotiation preparation, market analysis, fee-schedule review, contract modeling, and related revenue-integrity workflows.
Turn structured TiC data into provider leverage
Use the extracted evidence for market position, payer negotiation, and the contract lifecycle that follows.
Compare payer reimbursement against selected peers and markets
Rate benchmarkingBuild an evidence-led position for the next payer negotiation
Managed care contractingConnect market evidence to executable payer contract terms
Contract intelligenceAsk the question without building the pipeline
Show us the payer, provider, market, and code data your team needs. We'll demonstrate how Lumivera turns the raw files into a focused output.
Request a demo