Hospital Price Transparency Architecture & Managed Care Rate Integrity
An institutional cloud workspace for US health system executives and healthcare advisory alliances. Audit 100% of machine-readable file records against statutory 45 CFR Part 180 standards and reconcile commercial contract rate discrepancies.
One unified workspace, one engagement per hospital
Engineered for both Single Health Systems (facility portfolio governance) and Strategic Practice Alliances (multi-client advisory delivery). Add each hospital, upload its file, and keep every scan and workpaper organized in one place.
| CLIENT / HEALTH SYSTEM | TAX ID (EIN) | NPI | STATUS | WORKPAPERS | ACTIONS |
|---|---|---|---|---|---|
Client Health System 01 Sample engagement | XX-XXX4920 | 1487XXXX43 | Scan complete | 1 diagnostic scan | Launch Sandbox |
Client Health System 02 Sample engagement | XX-XXX8215 | 1928XXXX50 | Awaiting file | None yet | Launch Sandbox |
Client Health System 03 Sample engagement | XX-XXX4983 | 1039XXXX21 | Awaiting file | None yet | Launch Sandbox |
From a hospital's file to a finished audit
Four steps inside your firm workspace. The file is read as a stream in memory, so every row is evaluated and file size never forces a sample.
Create a client engagement
Add the hospital you are auditing, with its name, EIN and NPI, inside your firm workspace.
Upload the machine-readable file
Upload the hospital's published standard charges file in any of the accepted formats.
Sentinel Auditor runs
The file is streamed in memory and the 40+ point rule set is applied to every row. A diagnostic summary appears in the workspace.
Download the workpapers
The Compliance Audit & Workpaper Suite provides the Executive Audit Report (PDF) and the Remediation Error Ledger (CSV) for the engagement.
The same four rule domains on every file
A fixed rule set means two files audited a month apart are checked the same way, and every finding traces back to a rule.
CMS V3.0 statutory mandates
The header, identity and attestation fields every hospital file must carry before its prices can be trusted.
- Executive attestation and legal header
- 10-digit Type 2 organizational NPI
- Clinical setting values
- Pharmacy NDC unit of measurement pairing
Standard charges and methodology
- All five mandated charge types, with population completeness
- Five CMS methodologies, explanatory notes and payer-plan pairing
Billing code taxonomy
- 13 coding systems, code-to-description alignment
- Revenue code and J-code validation
Rate consistency
- Duplicate-code rate variance
- 365-day freshness
Rule domains as listed in the Sentinel Executive Audit Report.
Production workpapers for every facility engagement
Generated directly from the hospital's own machine-readable file across statutory compliance and commercial yield recovery. The examples below come from an anonymized hospital file.
Executive Audit Report
A board-ready diagnostic for the CFO conversation: one composite safety score for the file, the four weighted pillars behind it, and the exposure and remediation detail your teams need.
- Overall Composite Safety Score and grade for the file
- Statutory penalty exposure range under 45 CFR § 180.90
- Column-by-column CMS V3.0 alignment assessment
- Chargemaster defect coordinates and statutory 45 CFR § 180 citations
Multi-Domain Regulatory Safety Scorecard
Remediation Error Ledger
A row-level record of findings with 12 columns: source row, billing code, payer, billed charge, severity, rule citation, finding and remediation step.
| Source_Row_Number | Billing_Code | Billing_Code_Type | Payer_Plan_Name | Billed_Gross_Charge | Risk_Severity | CMS_Rule_Citation | Detected_Deficiency |
|---|---|---|---|---|---|---|---|
| 1572 | 38724 | CPT | Standard Commercial PPO | $900.00 | CRITICAL | 45 CFR § 180.50 - Hospital Price Transparency Requirements | Negotiated rate present but payer_name is missing. CMS requires payer identification. |
| 211 | L8699 | HCPCS | Standard Commercial PPO | MISSING | CRITICAL | 45 CFR § 180.50 - Hospital Price Transparency Requirements | Invalid Price Value: Missing required dollar standard charge where dollar amount is required by CMS v3.0 methodology. |
| 11 | 84143 | CPT | Standard Commercial PPO | $167.20 | CRITICAL | 45 CFR § 180.50 - Hospital Price Transparency Requirements | Negotiated rate present but payer_name is missing. CMS requires payer identification. |
Two specialized service deliverables
Sentinel Workbench opens in small cohorts so each organization gets dedicated engineering attention. Choose between statutory compliance auditing or commercial revenue yield recovery.
Compliance Audit Suite
Deterministic 45 CFR § 180 diagnostic audit against CMS Schema v3.0, statutory CMP liability modeling, and line-by-line chargemaster remediation error ledger.
- Executive Audit Report (PDF) with 4-pillar scorecard
- Remediation Error Ledger (CSV) with all 12 columns
- 45 CFR § 180.90 CMP exposure calculation
- Source row-by-row remediation coordinates for billing and IT teams
Revenue Yield Recovery Ledger
Commercial contract rate collision reconciliation, duplicate negotiated schedules, and rate dispersion analysis across competing commercial carriers.
- Revenue Yield Recovery Ledger (CSV) strictly in CSV format
- 100% of commercial contract rate collisions
- Unmasked commercial payer plans and rate schedules
- Commercial rate dispersion & variance analytics
Remediation tooling that Elite Data Solutions uses internally for Practice Co-Delivery. It is not part of the beta. A Workbench release is planned for a later phase.
Large files, processed in memory, in chunks.
Hospital machine-readable files can run to millions of rows. Spreadsheet tools stop at 1,048,576 rows per sheet, so large files are often sampled instead of read in full. Sentinel Auditor reads the file as a stream and evaluates every row, so file size does not decide how much of it gets checked.
We retain corporate facility identifiers and audit records only.
Statutory citations stay separate from internal checks.
Every ledger row carries a rule-citation column. Rows tied to 45 CFR § 180.50 cite the provision. Rows produced by Sentinel's internal rate-consistency and data-quality checks say so, so your team can tell a CMS requirement from an analytical flag before anything reaches a client.
In the example shown, one billing code appears twice under the same payer plan at two different rates. The ledger records both rates and the variance so the discrepancy can be reconciled in the chargemaster.
Spreadsheet review versus Sentinel Workbench
How a typical analyst workflow differs from a fixed, full-file audit.
Manual spreadsheet review
Sentinel Workbench
National Hospital Compliance Repository
Search our published diagnostic repository of audited US hospital systems under 45 CFR § 180. Evaluate peer health system compliance failure rates, benchmark statutory penalty exposure, and review target facilities across your firm's regional client roster prior to client engagement scoping.
Request Workbench Beta access
Tell us who you are and what you need. Applications are reviewed by the Elite Data Solutions team. Choose the briefing option to discuss Practice Co-Delivery.
Frequently asked questions
What is included in the Workbench Beta?
What do the services cost?
What files do I receive?
Does Sentinel certify compliance or provide government validation?
What happens to the files I upload?
How does Practice Co-Delivery relate to the Workbench?
Can a hospital or health system apply directly?
Run your first audit in the Workbench Beta.
Applications are reviewed in cohorts of 10 organizations.