Demystifying healthcare
prices for consumers

2026
Technology & Product Overview

SUPERSCRIPT'S MISSION

Real prices for patients in an industry that's only known estimates.

01Treatment

×

02Insurance

×

03Practice

=

04Realtime cost resolving $0.00

insured patient
prices instantly

THE PROTOCOL

A Three-Engine Agentic Solution to Healthcare's Most Complex Data Problem.

Superscript spent 3.5 years in R&D building Healthcare's First Pricing Protocol.

01ABE

ALL CLAIMS

43239 EGD 99213 E/M 76700 US Abd 29881 Knee Arthro

AETNA $1,371

CIGNA $1,198

HUMANA $1,442

Generates payer negotiated rates across procedures, providers, and payers.

ABE (Algorithmic Balancing Engine)

Financial, actuarial models built on adjudication outcomes to resolve payer/plan bundling logic and CPT nuance. Over 1TB+ of data ETL per practice.

02AIR

CLAIM

$642 DED $113 DED CVRD

CIGNA PPO

Patient X

An agentic benefits parsing engine to fully understand a patient's realtime coverage.

AIR (Accessing Insurance Resources)

Interprets X12 271 eligibility responses across EB segment hierarchies and free-text MSG fields using LLMs to normalize payer coverage logic complexity.

03ART

OUTPUTCIGNA PPO

43239EGD w/ biopsyDED$642.00

99152SedationDED$112.75

88312Special stainCVRDCovered

PATIENT OWES$1,112.45

CLAIM DATA → ← MODEL UPDATE

A feedback loop to continuously tighten our pricing accuracy.

ART (Adjudicating Real-time Transactions)

Reads every 835 remittance and maps each pricing discrepancy. 8,700+ weekly adjustments generate labeled training examples with unambiguous outcome signals, so the system self-corrects without human annotation or reward model drift.

ANONYMIZED SUPERSCRIPT CUSTOMER DATA · CY2025

Health system ambulatory collects just over half of what patients owe.

A hospital-affiliated physician group. An analysis of three of their markets over one calendar year: 81,857 claims and $5,344,378 of patient responsibility. Hospital professional fees, radiology and hospital outpatient all collect under 41%.

NEVER COLLECTED $0.00M

PATIENT YIELD 0.00%

SERVICE LINE · RANKED BY YIELDNOT COLLECTED

Ten of fourteen service lines, by dollars uncollected. The fourteen cover $4,300,889 of the $5,344,378 total. Best performer: urology, 77.67%.

ALL PATIENT BALANCES, BY COST-SHARE TYPE

The copay is the one number a front desk can quote today. It collects —. Most patient revenue becomes collectable when pulled to the front end.

A residual “other adjudicated” pool, 5% of the total, collects 38.28%. Not charted.

FOR PRACTICES

The EHR Browser

Your front desk captures the full patient cost-share in one click, at the moment they're most likely to pay.

Embedded in your EHR

Integrates directly into existing workflows. No change management.

Optimized for coinsurance and deductible collections

Practices already collect copays over 90% of the time, but leak revenue on deductibles and coinsurance.

Patient yield rises to over 92% when patients see a price they can trust.

Superscript Skylight: Epic EHR with the patient payment widget and POS device

Dana’s appointment on 08-27-26

Dr. Hollis @ 8:45am – 9:15am

Total paid: $0.00

Payment method: Visa ••• 5599

FOR CONSUMERS

Storefront

Surface upfront, transparent cost-share right in your booking flow.

Clarity and certainty for patients

Patients check eligibility and see accurate prices before they book, no surprises later.

An e-commerce-optimized growth channel

Practices finally get a modern acquisition channel, not just a booking form.

Specialty practices see conversion rates over 4%, beating e-commerce benchmarks by 71%. Urgent cares reach 21%.

ohiohealth.com/schedule/1932280906/orthopedic-and-sports-medicine/patientinfo

Enter Patient Information

OhioHealth Physicians Group Orthopedic and Sports Medicine, Circleville · Thursday, August 27, 2026 at 8:45 AM

Last name *

ZIP *

Primary phone *

Sex assigned at birth *

Powered by

Waiting for insurance…

New Patient Orthopedic Consultation · Level 4

New patient evaluation with an orthopedic surgeon at OhioHealth Physicians Group Orthopedic and Sports Medicine, Circleville.

$478.25

Self pay

Your Anthem Blue Cross and Blue Shield deductible has $1,243.60 remaining, so this visit prices at the full negotiated rate of $217.40

Calculating your price…

View details

FOR DEVELOPERS

Pricing, as an API.

Everything the storefront just did — eligibility, prediction, price — is three composable endpoints your team can build on.

Lean on our engines, or bring your own

Price from a Superscript eligibility check and prediction — or hand us your X12 benefits response and treatment codes and we price directly.

Answers, not codes

Every line item returns the patient's responsibility with a benefits breakdown, pricing tags, and a plain-language explanation. Accumulators deplete in sequence across a cart.

REST + MCP — the same pricing engine the storefront runs on, callable by your systems and your agents.

Pricing

POST /v1/pricing/estimates

Returns a patient-responsibility estimate for a set of treatments, given coverage. Two ways in: give us eligibility_check + prediction to lean on our engines, or pass eligibility + items to price against what you already have.

Every item carries a benefits breakdown, tags for how it was priced (copay, coinsurance, deductible, out-of-pocket max, contract, non-covered, self-pay), and a plain-language explanation. Amounts are in cents.

PARAMETERS

eligibility_check optional · string

Id of a Superscript eligibility check to price against.

eligibility optional · object

Your own eligibility response, passed inline. One of eligibility_check or eligibility is required.

prediction optional · string

Id of a prediction from /v1/predictions to price every predicted and likely code.

items optional · array

Explicit treatments to price, by cpt or hrt_id — with your own X12, no Superscript prediction needed.

Also available as an MCP tool for agent-based clients →

POST /V1/PRICING/ESTIMATES · PYTHONCOPY FOR CLAUDETRY IT ↗

estimate = client.pricing.estimates.create(
    eligibility_check="elig_8Kd93jf20",
    # or: eligibility=<your own benefits response>
    prediction="pred_5Qw72Lc19",
)

RESPONSE

{
  "id": "est_2Np64Xd83",
  "object": "pricing.estimate",
  "livemode": false,
  "currency": "usd",
  "items": [
    {
      "cpt": "99214",
      "hrt": { "id": 4021, "name": "Urgent care visit" },
      "kind": "predicted",
      "payment_type": "insured",
      "patient_responsibility": 5000,
      "allowed": 15500,
      "payer_responsibility": 10500,
      "breakdown": {
        "copay": 5000,
        "coinsurance": { "amount": 0, "percent": null },
        "deductible": { "applied": 0, "remaining_after": 90000 },
        "oop_max": { "applied": 5000, "remaining_after": 395000 }
      },
      "benefits": {
        "tags": ["copay"],
        "explanation": "Priced using your urgent care copay.",
        "service_type": "urgent_care"
      },
      "group": "grp_urgent_visit"
    }
  ],
  "totals": {
    "patient_responsibility": 5000,
    "allowed": 15500,
    "payer_responsibility": 10500
  },
  "benefits_summary": {
    "narrative": "COPAY",
    "explanation": "Flat urgent care copay — no deductible.",
    "patient_owes": 5000
  }
}

PROVEN SUCCESS

Proven across the largest group practices on Athena, and expanding across all EHRs.

[A] PATIENT AR TIMELINE ~1 day ↓ from 30+ days · -97%

[B] PATIENT YIELD 90%+ ↑ from a 60–75% baseline

[C] ADMIN TIME CALLING PAYERS & CHASING PAYMENTS -93% reported across live sites

[D] SUPERSCRIPT FOOTPRINT TODAY

812,256Transactions

261,726Patients

735Providers Live

2nd largest urgent-care group in NYC

URGENT CARE

23LOCATIONS

✓ Fully expanded See case study →

2nd largest GI specialist group in the country

GI

211LOCATIONS

Expansion underway See case study →

Largest multi-specialty MSO in New Jersey

MULTI-SPECIALTY MSO

43LOCATIONS

Expansion underway

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Demystifying healthcareprices for consumers