Reference-Based Pricing Simplified

Accurate, Proven, and Defensible
Health plans need reference-based pricing (RBP) that’s accurate, proven, and defensible – otherwise, they face pushback from providers, balance billing to members, and dissatisfaction for the employer group. But RBP calculations for reimbursement are often complex, inconsistent, and confusing.
Context4 Reference-Based Pricing makes reference-based pricing simple. We’re leading the way in the new age of healthcare pricing with our in-depth, accurate data and cutting-edge cloud technology. These ingredients combine to deliver a proven, defensible healthcare pricing solution with total Medicare gap-fill and unmatched accuracy.
Comprehensive and Adaptable
If it’s Medicare reference-based pricing (RBP) you need, Context4 Reference-Based Pricing uses the CMS Prospective Payment Systems within our real-time processing engine to calculate the pricing. For UCR RBP, we use our industry-leading UCR data. Either way, you get accurate and real-time pricing results.
Context4 Reference-Based Pricing is part of the Context4 Health Plans Suite, our modular, integrated technology platform. Implementation is effortless, and the service is secure, immediate, and reliable.

The Complete RBP Solution

All Medicare Prospective Payment Systems (PPS), fully automated

Cloud-based for easy implementation

Context’s leading UCR fee data

Updated weekly

The ability to have the solution return a percent of Medicare to you

No data to manage or software to maintain