What Hyve Health does

Hyve Health is a private healthcare technology company headquartered in Littleton, Colorado, that operates a healthcare transparency data platform serving U.S. hospitals, health systems, state hospital associations, and individual providers. The company aggregates de-identified 837 (claim) and 835 (remit) data from hospitals into a national benchmark used to score payer behavior on denials, prompt pay, reimbursement rates, and downcoding, and pairs that analytics capability with compliance tooling for federal price transparency and good faith estimate mandates.

Hyve Health's product portfolio centers on three flagship offerings sharing the same 837/835 claims data infrastructure. Vitality Payer Scorecard is the national payer accountability platform benchmarking payer performance across de-identified hospital-submitted claims and remittance data. Insight CMS Price Transparency generates CMS-compliant Machine Readable Files and patient estimators for the 300 shoppable services rule, drawing on historical claims, contract rates, and chargemaster data. GFE Exchange, a collaborative provider portal powered by the jointly-controlled Collectyve Health subsidiary, enables convening providers to coordinate Good Faith Estimates with co-providers and co-facilities under the No Surprises Act. A fourth product, Honee, is positioned as a forthcoming payer contracting intelligence tool. An internal PHI Scrubber de-identifies submitted data prior to ingestion, and the platform is SOC 2 Type 2 certified. By 2025, the platform reported processing over 779 million claims and 1 billion remits across more than 1,000 hospitals and 598,000+ mapped payer relationships.

The company monetizes primarily through SaaS subscriptions to Vitality Payer Scorecard and Insight, supplemented by managed services for ongoing CMS Machine Readable File compliance. Pricing is quote-based and not publicly disclosed, consistent with enterprise sales into hospital and health system buyers. Hyve distributes through direct enterprise field sales targeting revenue cycle leaders, managed care departments, and C-suite, augmented by partnership channels with the American Hospital Association, the Healthcare Financial Management Association, and 25-30+ state hospital associations. The company is led by founder and CEO Travis Gentry (originator of the ClearQuote patient estimation platform at Financial Healthcare Systems in 2005), supported by a distributed executive team spanning data, technology, growth, and client functions. No external funding rounds are disclosed in the source data.

Name

Hyve Health

Legal name

Hyve Health

Website

https://hyvehealth.com

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

11–50 employees

Short description

Hyve Health operates a healthcare transparency SaaS platform serving 1,000+ U.S. hospitals with payer performance benchmarking (Vitality Payer Scorecard), CMS price transparency compliance tooling (Insight), and No Surprises Act Good Faith Estimate coordination (GFE Exchange), distributed via HFMA and state hospital association partnerships.

Ownership category

akta.pro rank

Product category

Healthcare Transparency & Payer Performance Analytics Software

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

akta.pro secondary industries

Claims Administration & Payment Integrity (Medical/Dental/Vision) (HLAEALAD), Healthcare Billing & Patient Payments Presentment (FSAMAJAH), Consent, Authorization & Data Sharing Governance (opt-in/opt-out, DS4P) (HLACABAG)

Keywords

• Healthcare data analytics
• Payer accountability platform
• CMS price transparency
• Claims data benchmarking
• Revenue cycle analytics

Headquarters

HQ city

Chicago

HQ country

United States

HQ region

North America

Offices6 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations, Infrastructure

Revenue model

1. SaaS Platform Subscriptions: Subscription-based access to Vitality Payer Scorecard and Insight CMS Price Transparency platforms. Hospitals submit de-identified claims data and receive ongoing access to analytics dashboards, benchmarking reports, and compliance tools.
2. Compliance Services: Professional services for CMS price transparency compliance including MRF generation, hosting, maintenance, and updates as regulations evolve. Ongoing managed services for MRF files.

Go-to-market motion3 records

Distribution channels3 records

Marketing channels4 records

Core offering

Hyve Health operates a healthcare transparency SaaS platform that ingests de-identified hospital claims (837) and remittance (835) data to deliver a national payer accountability benchmarking platform, CMS Hospital Price Transparency compliance tools (Machine Readable Files and 300 shoppable services), and a collaborative Good Faith Estimate portal for the No Surprises Act. The platform serves more than 1,000 hospitals and is distributed through HFMA and 25+ state hospital association partnerships.

Product overview

Hyve Health is a healthcare transparency platform offering a portfolio of three core products. Vitality Payer Scorecard is the national payer accountability platform that aggregates de-identified 837/835 claims and remit data from hospitals to benchmark payer performance on denials, reimbursement rates, and prompt pay metrics. Insight CMS Price Transparency addresses CMS Hospital Price Transparency mandates by generating compliant Machine Readable Files (MRF) and patient-facing cost estimators from hospital claims data. GFE Exchange (powered by Collectyve Health) is a collaborative portal enabling providers to create and compile compliant Good Faith Estimates by inviting co-providers to contribute charges. An upcoming tool called Honee will address payer contracting. The products share a common data infrastructure built on 837/835 claims ingestion, serving more than 1,000 hospitals.

Differentiator

Problem solved

Functional benefit

Brands

• Vitality Payer Scorecard: National payer accountability platform backed by data from hospitals for hospitals, providing benchmark comparisons, accounts receivable and prompt payment information by payer
• Insight
• GFE Exchange
• Honee
• Collectyve Health

Products and services

• Vitality Payer Scorecard National payer accountability platform that aggregates de-identified hospital claims (837) and remittance (835) data to benchmark payer performance on denials, prompt pay, reimbursement rates, and downcoding across payer types, specialties, and regions; targeted at hospital finance, revenue cycle, and managed care teams.
• Insight CMS Price Transparency CMS Hospital Price Transparency compliance solution that generates compliant Machine Readable Files (MRF) using 837/835 claims and remit data, contract rates, and chargemaster (CDM), along with a patient-facing estimator for 300 shoppable services; targeted at hospital compliance and revenue cycle teams.
• GFE Exchange Collaborative provider portal for Good Faith Estimates required by the No Surprises Act; enables convening providers to invite co-providers and co-facilities to contribute charges, compile a complete estimate, and send it to the patient within one business day; powered by Collectyve Health. Targeted at physicians, ambulatory surgical centers, and ancillary providers.
• MRF Viewer Secure portal for hospitals and providers to view and manage the Machine Readable Files (MRF) generated by the Insight CMS Price Transparency product.

Quantifiable outcome

• Downcoding occurring in nearly 1 in 12 Medicare Advantage emergency department claims nationally based on analysis across 900 hospitals
• +1 more outcomes

Named customers6 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Four partnerships are on record, tiered core and flagship.

• State Hospital Associations (25+)coreGTM or Marketing Partner · 1 January 2025Partnership with 25+ state hospital associations to promote Vitality Payer Scorecard to member hospitals across the country. Associations use aggregated benchmarking data to support policy advocacy and legislative initiatives at state level.
• Healthcare Financial Management Association (HFMA)flagshipStrategic or Co-development Partner · 1 January 2024HFMA partnership provides national distribution and credibility for Vitality Payer Scorecard. HFMA officially backs the payer accountability initiative, lending industry authority to Hyve's data-driven approach to payer transparency. The partnership helps position the scorecard as an industry standard tool for hospital advocacy.
• American Hospital Association (AHA)coreStrategic or Co-development Partner · 1 January 2021American Hospital Association partnership for Vitality Payer Scorecard launch, providing national hospital industry backing for the payer accountability platform.
• Collectyve HealthcoreTechnology or IntegrationCollectyve Health powers the GFE Exchange collaborative portal for Good Faith Estimates. The technology enables convening providers to coordinate with co-providers and co-facilities to create comprehensive, compliant estimates as required by the No Surprise Billing Act.

Scale indicators6 records

Recent moves11 records

Expansion highlights6 records

Direct peers

• Turquoise Health: A healthcare price transparency platform that aggregates payer-negotiated rates and provides consumer-facing cost estimates. Directly competes with Hyve's Insight CMS Price Transparency product and shares the regulatory-compliance thesis of turning mandated transparency into provider intelligence.
• Kyruus: Provider data and network management platform sold to hospitals and health systems for patient access and provider directory use cases. Comparable enterprise sales motion to hospital systems and adjacent to Hyve's price transparency workflow that depends on accurate provider and facility data.
• AKASA: AI-driven revenue cycle automation platform serving hospitals and health systems on denials, prior authorization, and payer follow-up. Comparable customer base (hospital revenue cycle leaders) and adjacent use cases to Hyve's payer accountability and denial benchmarking solutions.
• Health Catalyst: Healthcare data and analytics platform serving hospitals and health systems with benchmarking and performance improvement. Comparable in aggregating hospital operational data for benchmarking use cases, with overlapping enterprise sales motion to hospital finance and operations leaders.
• Clarify Health: Healthcare analytics company that builds payer and provider performance benchmarks using claims data. Direct overlap with Hyve's Vitality Payer Scorecard value proposition of benchmarking payer behavior on cost, utilization, and quality for hospital and life sciences customers.

Broad incumbents

• Datavant: Health data exchange and de-identification infrastructure provider that connects claims and clinical data across organizations. Comparable to Hyve's data aggregation and PHI-handling capabilities, but operates as horizontal infrastructure for many buyers rather than a hospital-facing analytics product.
• Waystar: Large-scale healthcare payments and RCM platform that processes claims, remits, and patient estimates. Touches the same 837/835 data pipeline as Hyve and offers price transparency tooling, but as one component of a much broader enterprise RCM suite serving thousands of hospitals.
• FinThrive: End-to-end revenue cycle management platform that processes claims and remit data, including price transparency modules. Overlaps with Hyve across claims data analytics, payer benchmarking, and MRF generation, but as part of a much broader RCM portfolio rather than a transparency-focused niche.
• Experian Health: Large healthcare RCM and identity management vendor offering claims management, eligibility, and payment integrity tools. Operates on the same 837/835 data workflows as Hyve and competes for hospital revenue cycle budget, with overlapping price transparency and payer data capabilities.

Emerging players

• Avaneer Health: Emerging healthcare data exchange network focused on payer-provider interoperability and administrative data sharing. Overlaps with Hyve's mission of reducing friction in payer-provider data flows and is built on similar regulatory and consortium-driven theses.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Hyve Health