Know what payers actually pay before you admit.
A VOB tells you the patient is covered. PayerLenz tells you what the payer is likely to pay: reimbursement benchmarks built from real behavioral health claims, and real-time eligibility checks that return the patient’s benefits with that dollar figure attached. Built by the billing professionals at Revenue Logic.
- real claims analyzed
- 500,000+
- real claims analyzed
- payer groups
- 260+
- payer groups
- states and growing
- 19
- states and growing
The most expensive unknown in admissions
“Covered” isn’t a number
An active out-of-network benefit doesn’t tell you whether PHP pays $675 a day or $2,225 a day. In our pool, the same payer does both, depending on plan and reimbursement method. The benefit isn’t the rate.
You find out months later
The EOB arrives long after the care is delivered. That’s pricing discovery after the sale. By then, the census decision, the staffing, and the cost are already spent.
Every admit is a bet
Without rate expectations, admissions and utilization decisions run on instinct and anecdote. Your team deserves the actual distribution: what this payer has paid, how often, and how recently.
From “is it covered?” to “what will it pay?”
See the rate before you admit
Search what a payer has actually paid for behavioral health care, built from adjudicated claims in the PayerLenz pool.
- Most-likely rate plus P25 / P50 / P75 / P90 spreads per result
- Filter by payer group, state, level of care, and reimbursement method
- BCBS resolved to the alpha prefix and home plan
- Trust score on every figure, from claim volume and recency
- Year-over-year trends and reimbursement-percentage breakdowns
- Branded PDF, PNG, and JPEG exports
Real-time eligibility with a dollar answer
Enter the patient’s name, date of birth, member ID, and payer. In seconds, PayerLenz returns the payer’s live benefit response with the expected out-of-network reimbursement attached. One check, both answers: covered, and for how much.
- Coverage status, plan, group, and effective dates
- Deductibles and out-of-pocket maximums: individual and family, in and out of network, including amounts met and remaining
- Behavioral health cost-shares: copays, coinsurance, and prior-auth flags for mental health and SUD levels of care
- Limitations, exclusions, and behavioral health carve-out detection
- Expected out-of-network reimbursement for that payer, state, and level of care, on the same result
- Print to PDF, branded PNG and JPEG exports, and a 30-day check history
Your claims make it sharper and cheaper
Contribute de-identified claims data and earn up to 25% off your plan each cycle, or earn free searches on the free tier. Every contribution deepens the pool your own benchmarks are built from.
Now you know what payers pay.
Are you collecting it?
When the answer isn’t clear, that’s a billing conversation worth having. It’s the one we have for a living.
Talk to Revenue LogicSoftware from people who bill for a living
Revenue Logic is a white-glove revenue cycle firm built for behavioral health. We’ve spent our careers inside the work this software is made of: verifications, claims, payer behavior, and the reimbursement data underneath all of it.
PayerLenz is that experience, productized: the first product from Revenue Logic, built on a simple belief: billing shouldn’t be opaque, and it shouldn’t be your problem.
Kyle McHenry
FounderIn behavioral health revenue cycle since 2012. Kyle founded Revenue Logic, the white-glove revenue cycle firm built exclusively for behavioral health, and has spent over a decade inside the claims data PayerLenz is built on.
Preston Powell
Co-founderPreston has spent years helping treatment centers grow their census through digital marketing and admissions consulting, with more than 200 facilities served. His work closes the loop between marketing spend, admissions, and revenue.
Between them: both halves of treatment-center economics: getting patients in the door, and getting paid for the care. revenuelogic.io →
Stop admitting blind.
Start free with searches you earn by contributing data, or pick a plan and put real rate expectations in front of your admissions team this week.