CMS-0057-F requires health plans to make prior-authorization and claims-transparency data publicly discoverable via standardized APIs. Medigami tracks which payers actually comply, which have filed, and — where public regulator data exists — each payer's denial rate and appeal-overturn record.
A payer that isn't discoverable under CMS-0057 is harder to hold accountable, and harder for patients to compare before they enroll. This scoreboard exists so that information isn't buried in a regulatory filing nobody reads.
Every row on the scoreboard links to its underlying source — a state regulator filing, a CMS dataset, or the payer's own published API. No number here is an estimate presented as a fact; where we don't have verified data for a payer, the scoreboard says so.
If one of these payers denied your claim, the free Denial Decoder shows your state's external-review overturn rate and your exact filing deadline in under a minute.
Educational information only. Not legal, medical, or insurance advice.
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We check any medical bill against standard Medicare rates and flag overcharges, duplicates, and billing mistakes — in about 60 seconds.
Built for fertility patients: we check every line of an IVF bill, flag low-value add-ons, and include a cost estimator that uses your state's rules plus a clinic finder.
Educational tool — not legal, medical, or billing-counsel advice. Treatment and appeal decisions remain with you and your physician / counsel.