You pay every claim, but never see the price.
When you self-insure, every inflated charge and over-negotiated rate comes straight out of your bottom line, and your employees' paychecks. Yet most employers can't see what their plan is actually paying versus fair market rates. SumHealth changes that.
- Claim-level benchmarks
- Overcharge detection
- HIPAA secure
You pay the bill, but you can't see the price
Self-funded plans bear 100% of claim costs, yet the prices behind those claims are buried in network contracts and itemized bills no one audits against the market.
Overcharges hit your plan directly
Inflated facility fees and marked-up line items flow straight through to your plan spend. Without repricing, you pay them without ever knowing.
Rising costs, fewer levers
Premiums and claim costs climb every year. Shifting cost to employees has limits. The real opportunity is the pricing inefficiency hidden in the claims.
Stop-loss exposure you can't model
A handful of overpriced high-cost claims can blow through your stop-loss attachment. Without fair-market benchmarks, the risk is invisible until it lands.
No benchmark for "fair"
Your TPA shows what was paid, not whether it should have been. Without independent market data, there's no way to challenge an outlier charge.
Protect plan spend with independent pricing data
SumHealth gives benefits and finance teams the market benchmarks to spot overcharges, model stop-loss risk, and contain costs without touching benefits.
Reprice claims against fair market rates
Run employee bills and high-cost claims through line-by-line analysis to flag inflated charges before they hit your plan.
- Flag overcharged claims before payment
- Benchmark bills against fair market rates
- Reduce stop-loss exposure with proactive repricing
- Arm HR teams with actionable cost data
Audit what your network actually pays
Benchmark your plan's negotiated rates against the broader market to find where your network is paying above fair value.
- Compare your plan's rates against market
- Identify cost outliers by region and service
- Bring evidence to your TPA and network reviews
Get the exact dataset your plan needs
Request a bespoke pricing dataset scoped to your plan, your geographies, and your highest-cost service lines, built to your specification.
- Tailored to your markets and service lines
- Delivered in the format your team uses
- Built around your specific cost questions