Tools
Out-of-Network
The Out-of-Network Analysis tools - setup, the rate sheet, the run, one tool per results component, and the export.
These tools run an Out-of-Network Analysis end to end. They write to your account (a study, and an experimental CDM when you generate one). oon_next_step and the next_step on every result walk the assistant through them.
oon_next_step
| Parameter | Type | Default | What it does |
|---|---|---|---|
study_id | string | none | The study id, as returned by the create tool or the list tool of that study kind. |
oon_list_studies
| Parameter | Type | Default | What it does |
|---|
oon_create_study
| Parameter | Type | Default | What it does |
|---|---|---|---|
name | string | required | The study name. |
owner | string | required | The provider the rates belong to: a provider id or name in your account. A new name becomes a custom provider. |
oon_sources
| Parameter | Type | Default | What it does |
|---|---|---|---|
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_set_rates
| Parameter | Type | Default | What it does |
|---|---|---|---|
rate_table_version_id | string | required | |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_rate_sheet
| Parameter | Type | Default | What it does |
|---|---|---|---|
label | string | none | A label for this rate-table version, such as the fee schedule year. |
layout | list of object | none | |
payer_map | object | none | |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
upload_id | string | required | The id create_upload returned for the file. |
oon_set_utilization
| Parameter | Type | Default | What it does |
|---|---|---|---|
dataset_id | string | none | An existing volume or cost dataset in Data Sources; otherwise give upload_id and mapping. |
description | string | none | What the dataset holds and the study it is for; required for a new dataset. |
mapping | object | none | Which columns hold the code, the rates (one per payer) and the volume, per sheet: the suggested_mapping from inspect_upload, confirmed with the user. |
name | string | none | The study name. |
payer_map | object | none | |
source | string | required | |
state | string | none | Two-letter US state, for example FL. A state on its own is not enough: add codes, apc, q or hospital_ids. |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
upload_id | string | none | The id create_upload returned for the file. |
oon_set_charges
| Parameter | Type | Default | What it does |
|---|---|---|---|
cdm_version_id | string | required | A CDM version id to pin; omitted, the owner's effective CDM (its own, else its health system's) is used. |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_generate_cdm
| Parameter | Type | Default | What it does |
|---|---|---|---|
basis | string | max | |
label | string | none | A label for this rate-table version, such as the fee schedule year. |
overrides | object | none | |
publish | boolean | false | |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
uplift_pct | number | 0 |
oon_set_assumptions
| Parameter | Type | Default | What it does |
|---|---|---|---|
charge_overrides | object | none | |
charge_uplift_pct | number | none | |
codes | string | none | CPT, HCPCS or MS-DRG codes to look up. |
drop_band | number | none | |
payers_included | list of string | none | |
retention | number | none | |
retention_by_payer | object | none | |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
top_codes | integer | none |
oon_preview
| Parameter | Type | Default | What it does |
|---|---|---|---|
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_run
| Parameter | Type | Default | What it does |
|---|---|---|---|
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_sections
| Parameter | Type | Default | What it does |
|---|---|---|---|
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_payer_codes
| Parameter | Type | Default | What it does |
|---|---|---|---|
limit | integer | 50 | Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for. |
offset | integer | 0 | Rows to skip, for paging. |
payer | string | required | Only this insurer, as named in the data. |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
The other components
Each takes study_id and limit and returns the component's data (rows where it is a list): oon_headline, oon_totals, oon_assumptions, oon_provenance, oon_net_impact_chart, oon_break_even_chart, oon_payers, oon_report_executive_summary, oon_report_recommendation, oon_report_payer_detail, oon_report_sensitivity, oon_report_methodology.
| Parameter | Type | Default | What it does |
|---|---|---|---|
limit | integer | 50 | Most rows to return. Each tool has its own cap. On a free plan, paid data returns 8 rows whatever you ask for. |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |
oon_export
| Parameter | Type | Default | What it does |
|---|---|---|---|
format | string | Benchmark: xlsx, csv, sources or pdf. Strategic pricing: pdf, xlsx, proposal-csv, benchmarks-csv or mdc-crosswalk-csv. | |
study_id | string | required | The study id, as returned by the create tool or the list tool of that study kind. |