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For TPAs

Network and pricing benchmarks for TPAs

DataLily AI gives third-party administrators market rate context for every client plan, so they can price direct contracts and build stronger networks.

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What TPAs use DataLily AI for

  • Price direct contracts

    Set offers knowing how a provider’s rates compare with the market.

  • Build narrow networks

    See which providers serve each market and how their rates compare.

  • Report to employers

    Show self-funded clients how their provider rates compare with the market.

  • Check coverage rules

    See how other plans’ coverage rules compare with yours.

Common questions from TPAs

How do TPAs benchmark provider pricing for self-funded plans?

DataLily AI shows how a provider’s rates compare with the market, so TPAs can set direct contract offers with dated figures.

How can a TPA find providers for a narrow network?

DataLily AI shows which providers serve each of your clients’ markets and how their rates compare, so TPAs can build a narrow network anywhere in the US.

What rate benchmarks do TPAs use for reference-based pricing?

DataLily AI shows how each provider’s rates compare with the market for the same service, so TPAs can test a reference price before offering it. Every figure is dated and labeled Fact, Signal or Estimate.

About DataLily AI

DataLily AI is the world model for US healthcare: one connected view of every US healthcare market, so teams can decide where to grow, what to negotiate and where to invest with the whole picture in view. It covers all 50 states, from big cities to rural areas. Every figure is dated and labeled Fact, Signal or Estimate. There is nothing to install; setup happens on a call.

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