Learn · OON Underpayments

Data iSight Out-of-Network Underpayment Resources

Data iSight is a repricing platform owned by MultiPlan (now Claritev). When it cuts your out-of-network payment, the appeal goes to the insurer, not the vendor.

Written for providers and hospitals, billers, and patients.

Data iSight is a repricing platform owned and operated by MultiPlan (now Claritev). It processes millions of out-of-network claims for insurance companies across the country. When you see "Data iSight" on a remittance notice, it means your claim was repriced by this third-party vendor before payment.

The most important thing to know: you appeal the insurance company, not Data iSight. The vendor only repriced the claim. The plan is the one legally responsible for paying you.

Appeal the insurer, not the vendor

The insurance company or plan administrator is legally responsible for paying you. Data iSight is just a vendor. Direct every appeal to the plan's appeals department and ask it to override the Data iSight repricing.

How it works

What Data iSight does

Data iSight applies MultiPlan's proprietary algorithms to out-of-network claims, reducing payment amounts to what the platform determines is a "market rate." Claims are often reduced by 60 to 80 percent below billed charges.

The insurance company pays Data iSight a percentage of the savings, creating a financial incentive to lower payments.

Active federal litigation

Data iSight and MultiPlan are currently defendants in federal antitrust litigation (MDL 3121, Northern District of Illinois) alleging systematic underpayment of out-of-network claims. A judge allowed the case to proceed to discovery in June 2025.

Providers who received out-of-network payments repriced by Data iSight or MultiPlan may have rights related to this litigation. (Status as of June 2026.)

Step one

How to identify Data iSight underpayments

Signs on your remittance notice

  • "Data iSight" explicitly mentioned in the remark text or adjustment description
  • Adjustment code CO-45 (contractual adjustment) with a reduction you did not authorize
  • Payment significantly below your billed charges
  • A network name that does not match the patient's insurance card
  • A reduction with no explanation or remark code (hardest to catch)

Step-by-step identification

  • Examine each claim line on the remittance notice
  • Compare the allowed amount to your billed charges
  • Look for "Data iSight" or repricing language in remarks
  • Build a spreadsheet of repriced claims to identify patterns over time

The process

How to appeal Data iSight underpayments

Direct the appeal to the plan, document the repricing, and benchmark what you should have been paid.

  1. 1

    Appeal to your insurance company

    • Find the plan's contact information on the patient's insurance card or EOB
    • Contact the plan's appeals or disputes department
    • State that your claim was repriced by Data iSight without authorization
    • Request the plan override the repricing and pay your full billed amount
    • Include your billed charges and market-rate benchmarking data
  2. 2

    Provide supporting documentation

    • Your itemized bill and CMS-1500 or UB-04 claim form
    • Medicare fee schedule rates for your CPT code and geographic region
    • FAIR Health or specialty-specific benchmarking data
    • Statement that Data iSight repricing was not authorized
    • Copy of the remittance notice showing the Data iSight adjustment

Build your file

Documentation you will need

When you appeal the insurance company, provide this documentation to support your case. Specific regulatory forms vary by plan and state. For detailed step-by-step documentation requirements, see our ERISA appeals guide. Here are the general document categories.

  • Remittance notice showing the Data iSight repricing
  • Your itemized bill and CMS-1500 or UB-04 claim form
  • Complete medical records supporting medical necessity
  • Medicare fee schedule rates for your CPT code and geographic region
  • FAIR Health or specialty-specific benchmarking data
  • Statement that Data iSight repricing was not authorized
  • Copy of the remittance notice showing the Data iSight adjustment
  • Required regulatory and appeal forms specific to your plan (varies by insurance company and state)

Reference & tools

Find what you should be paid

Out-of-network claims have no insurance company contract. Use these resources to find what Medicare and commercial insurers typically pay for your services in your geographic area.

Keep reading

Related guides

OON underpayments overview

How out-of-network repricing works and how to push back across vendors.

Read

MultiPlan repricing

The parent platform behind Data iSight (now Claritev) and how to dispute it.

Read

Zelis repricing

Another common out-of-network repricing vendor and how to appeal it.

Read

ERISA appeals guide

The step-by-step appeal process for employer-sponsored health plans.

Read

Appeals glossary

Plain-English definitions of ERISA, IDR, QPA, SPD, and the rest.

Read

Appeal deadlines

Every filing window, in one reference.

Read

Disclaimer

This guide is for informational purposes only and does not constitute legal or medical advice. Appeal It Now provides administrative support and appeal preparation services only; we are not a law firm. Please consult a qualified professional for advice specific to your situation.

Version 2.0 · Updated June 2026