Upload your data. The agent finds where you overpay — and proves it.
Give it the minimum (your carrier and where your members live) or the maximum (a de-identified claims feed). The more it has, the deeper it goes.
Upload your data
From carrier + market to a de-identified claims feed. No PHI to start; claims stay in your own environment when you add them.
Find it — and prove it
Every claim is checked against what other payers pay at that provider, and cheaper nearby facilities — flagged as overpaying or not, with every number traced to its source.
Get the plan
Sourced findings plus a granular plan: what to renegotiate, where to steer, which payer to switch to — and continuous monitoring as new data lands.
See exactly how the analysis works, step by step.
Ideally, the employer or TPA gives us de-identified, claim-level data for every enrollee.
| Member | Code | Procedure | Facility | Paid |
|---|---|---|---|---|
| M-0418 | 45378 | Colonoscopy | Berkshire Medical Ctr | $2,150 |
| M-1190 | 73721 | MRI, knee | Berkshire Imaging | $1,290 |
| M-0772 | 70553 | MRI, brain | BMC Outpatient | $2,640 |
| M-0915 | 29881 | Knee arthroscopy | Berkshire Surgical | $8,400 |
| M-0331 | 66984 | Cataract surgery | Berkshire Eye | $4,820 |
| M-1846 | 47562 | Lap. cholecystectomy | BMC Surgery | $12,400 |
| M-2031 | 99213 | Office visit | Pittsfield Internal Med | $148 |
| M-0677 | 64483 | Epidural injection | Berkshire Pain Center | $3,100 |
Synthetic illustration — the benchmark column (stages 3–4) is live against fact_rate via /v1/resolution/benchmark.
Our agent cleans and standardizes every claim — normalizing codes, resolving providers to an NPI, matching facilities — so each can be compared. Every step is audited.
fac “BMC-OP-3”
UHC-PPO-2 · $2,150
NPI 1043… · Berkshire Medical Ctr
payer UHC · $2,150
Synthetic illustration — the benchmark column (stages 3–4) is live against fact_rate via /v1/resolution/benchmark.
For each claim, we compare what was paid to that exact provider — against the real local price distribution for the same code.
Then we group by procedure. Each claim is compared to the live market for its code, then summed.
Procedures roll up into categories. Here’s how outpatient surgery adds up.
one of five categories · $3.4M total identified
Synthetic projection — illustrative figures. The benchmark column (stages 3–4) is live against fact_rate via /v1/resolution/benchmark.
The output: a granular plan — what to renegotiate, steer, or switch, line by line.
Synthetic projection — illustrative figures. The benchmark column (stages 3–4) is live against fact_rate via /v1/resolution/benchmark.
Across 2,404 paid claims in Q1 2026, Vlada identified $3.1M in estimated overpayment concentrated in three categories:
Every finding carries source lineage back to the relevant TiC MRF and peer-plan benchmark. Would you like to drill into one, or export a board-ready summary?
The output is a document your board can read and your counsel can defend.
- Renegotiate DRG 470 bundle at Facility Y
- RFP competing TPA for outpatient imaging
- Evaluate transparent PBM for specialty infusion