for your
24/7 Financial + Regulatory Intelligence for your outpatient center
No Excel wizardry. No portal hopping. No six-month implementation.
The problem
Financial & Reimbursement
Across Medicare and commercial payers, outpatient centers receive roughly half of what hospital outpatient departments get for the same procedure, and the gap widened again in 2026.
For over 150 CPT codes, patients pay more out-of-pocket at your ambulatory center than they would at the hospital, because the HOPD copay cap doesn't apply to outpatient surgery centers.
Hospitals collect over $28,000 for a total knee that your center reimburses at $8,400. That ratio holds across payers and procedures — and most outpatient centers negotiate contracts without ever seeing the comparison.
Regulatory & Quality
Leapfrog's 2026 public reporting expansion now scores thousands of outpatient centers on 13+ measures. Patients and payers can see how you compare. Can you?
Miss an ASCQR reporting deadline and you lose your annual payment update. The deadlines shift. The requirements compound. One missed submission costs real money.
Outpatient centers outnumber hospitals in the U.S. — but your quality scores don’t appear where patients and payers actually compare providers. Leapfrog is filling that gap in 2026. Your competitors already submitted.
What the agents query
Medicare is just the free starting point. Agents query across public and commercial data layers, so you don’t have to.
Free: start now
Start with public Medicare, quality, and supplier benchmarks before you ever upload a file.
Medicare ambulatory rates
Every CPT on the covered list, by region and wage index
OPPS hospital rates
Side-by-side hospital outpatient rates for the same procedures
ASCQR quality data
13+ CMS measures across thousands of outpatient centers, benchmarked nationally
Open Payments
Physician-manufacturer payments and transfer-of-value data
DMEPOS pricing
Device, prosthetic, and supply cost benchmarks
Unlock with early access
Add commercial reimbursement and hospital pricing layers when the question moves past Medicare.
Commercial payer rates
In-network negotiated rates from Transparency in Coverage files
Hospital standard charges
Hospital-posted prices from price transparency MRFs
Part B drug pricing
ASP payment limits and NDC-HCPCS crosswalks, updated quarterly
Bring your own
Layer in contracts, claims, and internal benchmarks once you want center-specific recommendations.
Custom datasets
Ingest claims files, internal contracts, or proprietary benchmarks. The agents query it all.
How it works
No six-month implementation. No portal hopping. Describe what you need: agents query across every data layer to build it.
Ask in plain English
Describe what you need: a payer negotiation brief, a quality benchmark report, a copay disparity analysis. Agents understand CPT codes, payer names, regions, and quality measures.
Example query
“What does Medicare pay for CPT 27447 at my ASC vs. the hospital? How does that compare to what Aetna negotiated in the Bay Area?”
Agents query across data layers
One question hits ambulatory center rates, OPPS comparisons, commercial payer Transparency in Coverage files, hospital charges, and quality data. No manual lookups across portals.
Review a structured report
You get a report with sections you can approve, edit, or ask to deepen. Share with your board, hand to your payer rep, or export as PDF.
Who this is for
You negotiate payer contracts, submit ASCQR data, and manage margins on flat reimbursements. We give you rate benchmarks across Medicare and commercial payers, quality comparisons, and evidence packs, with no EHR integration required.
You need to know if a case makes money at your center. We show you ambulatory vs. HOPD rates across all payers, commercial benchmarks, and hospital charges by CPT and region, so you can model case economics.
You're benchmarking implant costs without benchmarks. We surface DMEPOS pricing, Open Payments vendor data, and hospital standard charges so you can negotiate from evidence.
You need code-level rate disparity data, copay cap impact reports, and quality evidence for legislative briefs. We query it in seconds across Medicare, commercial, and quality datasets.
FAQs
If you are wondering whether this is another dashboard, another integration project, or another consultant engagement, start here.
Start with the question already slowing down a decision: What does Medicare pay for a CPT at our center versus the hospital? Which payer looks under market in our region? Where are we exposed on quality reporting?
No. The first layer of value comes from public Medicare, quality, and transparency data that is publicly available.
You can start with Medicare ambulatory rates, hospital outpatient comparisons, ASCQR quality benchmarks, Open Payments, and DMEPOS pricing. Early access expands that with commercial payer rates, hospital standard charges, and guided report workflows.
Yes. Early access is designed to combine your internal data with the public market benchmarks, so your contracts, fee schedules, and claims extracts can sit inside the same report as Medicare, payer, and hospital comparisons.
Most providers do not need to share PII or PHI to get value from CareParse. The first layer runs on public Medicare, quality, and price-transparency data. In the product itself, HealthClaw Agent keeps the public MCP surface narrow and read-only, HealthClaw Core can run behind bearer-auth and transport-security controls, and uploaded files for the landing assistant are staged in temporary storage rather than required for the workflow. SOC 2 Type II readiness, GDPR readiness, and broader healthcare compliance work are underway.
CareParse is for ASC administrators, surgeon-owners, materials leaders, and policy teams who need margin and quality intelligence.