An open, sourced map of US healthcare payer connectivity — payer IDs, crosswalks, and enrollment across clearinghouses. Every fact is public, cited, and dated.
Status: early. Foundation (schema + provenance gate + first records) is being built in the open. Not yet a complete reference — see what's here.
Clearinghouses (Optum/Change Healthcare, Availity, Waystar, Office Ally, Claim.MD, Stedi) hoard the knowledge of how to reach each payer — payer IDs, enrollment quirks, companion-guide details — in private lists that don't agree with each other. When a practice switches or runs a failover clearinghouse (now standard after the 2024 Change Healthcare outage), they re-map every payer ID by hand. There is no open, machine-readable map of who connects to whom and how.
This project publishes that map. It does not route claims or hold payer contracts. It's reference data, built from public sources and first-hand knowledge — never by copying a clearinghouse's proprietary database.
schema/payer.schema.json— the record shape (one file per payer line).data/payers/*.yaml— the payer records (seeded, growing).ci/validate.mjs— the provenance gate: everyverifiedfact must cite a resolvable source; stale facts get flagged.ci/build.mjs— builds the canonicaldist/payers.json.
Run it:
npm ci
npm run validate # provenance gate
npm run build # → dist/payers.json
Every crosswalk value carries a confidence badge and its source:
- VERIFIED — confirmed against a cited primary source.
- REPORTED — contributed but unconfirmed (shown, never trusted blindly).
- INFERRED — derived, not directly observed.
CI blocks any verified fact without a resolvable source. Nothing is ever presented
as verified without provenance.
Read CONTRIBUTING.md. The short version: cite your sources, mark your confidence honestly, never submit a clearinghouse's proprietary data, and sign off your commits (DCO).
- Code: MIT — see LICENSE.
- Data: CC-BY-4.0 — free to use, including commercially, with attribution to The Payer Map. See LICENSE-DATA.md.