Outfox Health

What is Outfox Health?

Outfox Health is an AI-powered price intelligence platform — the answer engine for health benefits. Outfox helps self-funded employers reduce medical spend by guiding employees to lower-cost, higher-quality care inside the health plan they already have. No carrier changes. Live in under 30 days.

How is Outfox different from AI health benefits tools like Garner, Healthee, or Quantum Health?

Most navigation tools focus on finding the right doctor. Outfox focuses on the facility — where the biggest cost differences actually live. The same MRI, surgery, or infusion can cost multiples more depending on where care happens, even inside the same network. Outfox uses your actual contracted rates and benefits data to guide employees toward lower-cost, high-quality care before expensive decisions are made.

What networks does Outfox work with?

Outfox works with any carrier that publishes machine-readable files under the Transparency in Coverage rule. This includes major commercial networks — Blue Cross Blue Shield, UnitedHealthcare, Cigna, Aetna — and regional plans such as MedCost and Sentara.

Do employers need to change their carrier or network to use Outfox?

No. Outfox works inside the plan you already have. No carrier changes, no network changes, no plan redesign required.

How long does implementation take?

Standard implementation takes under 30 days. Outfox requires only plan documents (PDFs) and an eligibility feed. No claims feed required to launch.

Where does the pricing data come from?

Outfox pulls contracted rates directly from your carrier's Transparency in Coverage machine-readable file — the actual negotiated rates your plan pays, not modeled estimates or network averages.

How is provider and facility quality measured?

Quality is measured using FoxIndex — episode-level clinical outcomes data covering 100M+ patients annually. FoxIndex scores providers and facilities on complication rates, readmissions, ER visits, and length of stay, benchmarked against peers in the same state. Higher price does not mean higher quality.

Does Outfox require a claims feed?

No claims feed is required to launch. Claims data can be integrated later to enhance reporting.