Transparency for You, the Provider
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Health plans and other payers access Data iSight™ to determine
an appropriate claim payment when their plan members seek care from providers not
participating in their PPO network(s). A key feature of Data iSight is this website,
which gives you a better understanding of how these payment amounts are determined.
The website makes the process for determining appropriate payment transparent to
you so that you may become a more informed healthcare partner, and to assist you
with any questions about how this claim was reduced. It also provides the information
to the health plan payer and the patient so all parties involved in the billing
and payment process have a clear understanding of how the reduction was calculated.
Data iSight does not replace the need for you to understand and comply with the
terms and conditions of the patient's health plan benefits. Please refer to health
plan materials and the remittance advice to understand how the benefits were applied.
Data iSight is only used to complement those materials and help you to understand
how the benefits were paid.
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