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What is HexIQ?

HexIQ software provides users with rapid and easy access to negotiated rate data, allowing them to search, download, and analyze complex healthcare reimbursement rates linked to specific codes, payers, providers (NPI), or tax identification numbers (TIN), thus promoting transparency in coverage criteria for improved business decisions and negotiation strategies. Each month, the software processes a vast array of machine-readable files (MRFs) from different payers, thoroughly cleaning and enhancing the data by adding relevant provider names, addresses, and network affiliations, and continuously updating it to enable users to compare their negotiated rates with those of peers in the same specialty and geographical location without relying on cumbersome Excel spreadsheets. With advanced search functionalities, users can filter results based on various criteria such as code, specialty, state, place of service, payer, NPI, or TIN, while also having the ability to export their findings in CSV format for more detailed analysis. Additionally, integrated analytics and visualization tools offer insights into rate distributions, average and mode rates, and contracted provider networks, enabling users to better comprehend market trends. This all-encompassing method not only simplifies the data retrieval process but also equips healthcare professionals with the information they need to make well-informed strategic choices based on trustworthy data. By harnessing the power of HexIQ, stakeholders can navigate the complexities of healthcare reimbursement with greater confidence and clarity.

What is CareCost Estimate?

CareCost Estimate delivers a comprehensive solution tailored for infusion centers and specialized medical practices, addressing a frequent question from patients: what is the expected cost of treatment? By inputting details such as medication, dosage, and insurance information, staff members can quickly calculate the patient's out-of-pocket expenses, often in under 90 seconds. This estimate takes into account various elements, including Medicare Part B coinsurance, any secondary insurance, Medigap coverage, weight-based dosing, and potential vial waste considerations (JW/JZ). Additionally, it factors in any available manufacturer copay assistance programs and foundation grants that the patient might qualify for, ensuring that the provided estimate accurately reflects the patient's financial responsibility. Beyond just cost calculations, the platform also offers valuable insights into payer requirements, outlining necessary prior authorizations, step therapy guidelines, and site-of-care conditions, all derived directly from the payer's policy documents with relevant links for easy access. The pricing data is based on the CMS Average Sales Price files, which are updated quarterly, and importantly, since the estimates are generated within the browser, patient information remains confidential and is not sent to outside servers. Furthermore, CareCost enhances its offering by providing free resources on billing and coding practices, including infusion CPT codes, J-codes, and modifiers, as well as a quarterly Infusion Reimbursement Index that aids healthcare providers in optimizing reimbursement processes. This comprehensive approach not only streamlines cost estimation but also supports healthcare professionals in navigating the complexities of patient billing.

Media

Media

No images available

Integrations Supported

Google Sheets
Microsoft Excel
Microsoft Power BI
Tableau

Integrations Supported

API Availability

Has API

API Availability

Pricing Information

$25 per month per code

Pricing Information

$189/month (first seat), $89/m
Free Trial Offered?

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Web-Based Support

Training Options

Documentation Hub

Training Options

Documentation Hub

Company Facts

Organization Name

HexIQ

Date Founded

2022

Company Location

United States

Company Website

www.hexiq.com/platform

Company Facts

Organization Name

CareCost

Date Founded

2026

Company Location

United States

Company Website

carecostestimate.com

Categories and Features

Healthcare Analytics

Not specified

Categories and Features

Medical Billing

Not specified

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