Realsight – Price Transparency Analytics

RealSight™ is CitiusTech’s price transparency platform that ingests and refines publicly available Machine Readable Files (MRFs) to deliver an end-to-end data and analytics capability for payers, providers, and members. Designed around the federal “Transparency in Coverage” Rule effective July 1, 2022, the solution processes MRFs containing cost-sharing and pricing details for covered services, including in-network negotiated rates and historical out-of-network allowed amounts. Built on CitiusTech’s Machine Readable File Engine (MRFE) for health plans, RealSight™ leverages this regulatory compliance foundation to support use cases such as network rate optimization, contract negotiation, narrow network enablement, merit-based steerage, and benefit design for insurance products.

Within this Health Care Software offering, RealSight™ provides several components: an enriched Data-as-a-Service layer for large-scale MRF ingestion and storage, a secure cloud environment to blend MRFs with enterprise datasets for operational analytics, and benchmark reporting via BI dashboards for provider rate comparison. It also includes a packaged analytics library with purpose-built dashboards for network management, contract negotiations, and benefit design; Analytics-as-a-Service for embedding insights and conversational AI into existing systems; and a data quality scorecard to assess payer MRF ingestion, profiling, and monthly trends. The SaaS-based platform supports large pricing datasets from multiple payers, delivers curated monthly data in a consumable format across the payer value chain, applies data quality checks and standardization with clinical equivalence, offers extensibility to additional payer data domains such as claims, quality, and membership, provides customizable dashboards for specific payer workflows, and helps lower operational costs associated with hosting and managing very large datasets.