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demand-driven-open-data / ddod-intake

"DDOD Intake" tracks DDOD Use Cases using GitHub issues. View the main DDOD site here
http://ddod.us
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Centralized method to retrieve current Medicare pricing by CPT #1

Closed dportnoy closed 9 years ago

dportnoy commented 9 years ago

Problem: Currently, you have to go to multiple sites and download inconsistent excel or CSV files to capture this data.

Solution: Centralized dataset or API that includes Medicare pricing for each CPT and locale

Value: This solution provides price transparency for consumers and enables companies to provide cost transparency tools. CMS often sets the pricing standards for private insurers as well.

dportnoy commented 9 years ago

Created page for full use case specifications and solution: http://hhs.ddod.us/wiki/Use_Case_1

ftrotter commented 9 years ago

The problem with a system like this is the many factors that go into calculating a given CPT code. Like location (i.e. state/Zip etc) and whether it is hospital or provider based. Other kickers...

It might be possible to solve this using the X12 EDI standards.. I vaugely recall some kind of "query for price" functionality defined in one of the lesser used standards... Then you put a RESTful/OAuth API on top of it... magic.

-FT

dportnoy commented 9 years ago

Closing. Moved to "Leads" section (demand-driven-open-data/DDOD-Leads#10) until this request could be defined as a use case.