Thalarx — Payer Evidence Platform
WorkspaceKelsey-Seybold Medical GroupBuilt from public federal data — no private information
Built from public federal data — no private informationThis organization is not a Thalarx customer and has provided nothing. Every figure on every surface of this workspace was cut from a published federal file, and the renderer refuses any figure that was not.
Methodology

Where every figure comes from

Thalarx draws on 24 reference planes across 6 families. Every rate, actual, quality mark, and dispute outcome stored by the platform carries the published file it came from and a locator precise enough for a human to re-check it.

The full registry

The board above is what this database holds facts from today. The catalogue below is the registered plane family list — the intended coverage, of which the loaded planes are a subset. The two are different questions and are shown separately on purpose.

Rates & Payments · 9

PlaneRoleAccessCadence
Hospital Price Transparency MRFsPrimary source of hospital negotiated rates by payer and plan. Per-hospital discovery, wildly inconsistent schemas — the hardest and most valuable plane in the registry.probeannual
Payer Transparency in Coverage MRFsPayer-side view of negotiated rates. Enormous files; the cross-check against hospital-published MRFs and the way to see what a payer pays competitors.bulkmonthly
Medicare Physician & Other Practitioners PUFActuals: services, average billed, allowed, and paid per NPI per code. Populates the actuals table and grounds every benchmark in observed volume.bulkannual
Medicare Physician Fee Schedule (PFS)The denominator. Percent-of-Medicare is the lingua franca of rate negotiation; without PFS no commercial rate is interpretable.bulkannual
Hospital Outpatient PPS Addenda (OPPS)Outpatient Medicare benchmark by APC. The hospital-outpatient counterpart to PFS.bulkquarterly
IPPS / MS-DRG payment filesInpatient Medicare benchmark. DRG weights plus wage-index adjustment are required to make any inpatient case-rate comparison honest.bulkannual
Clinical Lab, ASC, and DMEPOS fee schedulesBenchmarks for the ancillary settings that fall outside PFS and OPPS. Frequently where the largest unexamined rate gaps sit.bulkquarterly
Medicare Hospital Provider PUFs (Inpatient & Outpatient)Hospital-level actuals keyed by CCN. The facility analogue of the practitioner PUF.bulkannual
HCRIS hospital cost reportsCost structure and payer mix by facility. Turns a rate argument into a margin argument — the only plane that shows what care actually costs the provider.bulkquarterly

Codes · 5

PlaneRoleAccessCadence
HCPCS Level IIPublic code set for supplies, drugs, and non-physician services. Freely redistributable — carries descriptors we may show verbatim.bulkquarterly
CPT (licensed)The dominant procedure vocabulary. LICENSED — descriptor text may not be redistributed without an AMA agreement. Thalarx ships its own plain-language descriptions (packages/reference-data/descriptors.ts) until a license is in hand.citeannual
ICD-10-CM / ICD-10-PCSDiagnosis and inpatient procedure vocabulary. Required to interpret DRG assignment and case-mix arguments.bulkannual
NCCI edits and Medically Unlikely EditsWhich code pairs may be billed together and at what unit ceiling. Distinguishes a genuine underpayment from a claim that was never payable as billed.bulkquarterly
Groupers (MS-DRG, APC, APR-DRG)Maps coded encounters to payment groups. Without grouper logic, inpatient and outpatient rate comparison is guesswork.bulkannual

Provider Identity · 2

PlaneRoleAccessCadence
NPPESIdentity spine. Resolves an org name plus state into the NPI roster that defines a tenant footprint — the first call made at onboarding.apimonthly
POS / CCN crosswalkBridges NPI to CCN to facility. The join that lets practitioner-keyed and facility-keyed planes describe the same organization.bulkquarterly

Quality · 5

PlaneRoleAccessCadence
CMS Care ComparePublic star ratings and measure-level quality data. The most widely recognized quality currency in a payer conversation.apiquarterly
HRRP / HAC / VBP penalty programsPenalty and incentive standing. Converts quality position into a dollar figure Medicare already assigned.bulkannual
STS National DatabaseCardiac surgery outcomes at specialty depth. Where a cardiac program's leverage actually lives; cited rather than bulk-ingested.citeannual
SRTRTransplant program outcomes. Small number of tenants, but for those tenants it is the decisive quality plane.citebiannual
Hospital rankings and recognitionsReputational marks. Weak evidence analytically, real leverage rhetorically — carried as citations, never as computed quality.citeannual

Disputes & Enforcement · 2

PlaneRoleAccessCadence
Federal IDR Public Use FileNo Surprises Act arbitration outcomes: who filed, who won, awards against QPA. Populates disputes and is the strongest single negotiating exhibit.bulkquarterly
Payer policy watchtowerDetects payer policy changes before they hit remittance. Per-payer crawl with change detection; the early-warning plane.probecontinuous

Market Context · 1

PlaneRoleAccessCadence
Commercial rate and market studiesRegional price-level and concentration context. Frames a tenant's position against the market rather than only against Medicare.citeannual