Licensing
Transparent Pricing. Complete Access. No Surprises.
Simple, All-Inclusive Licensing
At Pilot Information Systems, we believe pricing should be as efficient and transparent as the solutions we deliver. That’s why our licensing is built around a single, predictable monthly fee — tailored to your organization’s size and claims volume.
No hidden fees. No add-ons. No surprises.
Everything featured on our Solutions page is fully included in your fixed monthly fee — giving you complete access to our technology, analytics, and support from day one.
While many competitors charge based on the savings they uncover, Pilot takes a different approach. Our platform applies more than 6.5 million advanced edits to every claim, yet you’ll never pay extra for the value we help you identify.
The only exception is for clients who elect to incorporate Medicare LCD/NCD rules. In those cases, the standard monthly access fee charged by the Centers for Medicare & Medicaid Services (CMS) for these files is passed through at cost — without markup.
The result? Greater clarity, stronger financial outcomes, and a partner fully aligned with your success — not your spend.
Deployment Options
Choose the deployment model that fits your IT environment, security posture, and operational preferences.
On-Premise
Deploy Pilot’s claims-edit software entirely inside your own data center. You retain full control of the operating environment, data residency, and integration with internal claim adjudication systems.
- Runs on Linux or Windows server environments
- Integrates with most claims platforms via standard batch interfaces
- Edit-library updates delivered monthly
- Implementation, training, and ongoing technical support included
- Preferred for organizations with strict on-premise data policies
Hosted / SaaS
Let Pilot operate the platform in a secure, compliant hosted environment. You retain full visibility into edit results while reducing your in-house infrastructure footprint and operational overhead.
- Fully managed infrastructure, updates, and monitoring
- Secure file-transfer protocols for batch and pre-pay flows
- Automatic monthly edit-library refreshes
- Scales with your claim volume — no infrastructure ceiling to plan around
- Preferred for organizations seeking faster time-to-value
What’s Included in Every License
- Complete edit library — over 6.5 million NCCI, MUE, LCD/NCD, add-on, frequency, age/sex, bilateral, rebundling, and other industry-standard edits
- Duplicate-claim detection — configurable user-defined criteria across a dozen claim attributes
- Pre-pay and post-pay modes — apply edits before adjudication for prevention, or retrospectively for recovery
- Reporting and analytics — edit-by-edit results, recovery opportunity reports, and trend analysis
- Monthly edit-library updates — including quarterly NCCI/MUE refreshes and CMS source-data syncs
- Implementation and onboarding — file format mapping, sample testing, and go-live support
- Training — for analyst, IT, and management users
- Ongoing technical support — issue resolution, edit-rule guidance, and configuration assistance
Frequently Asked Licensing Questions
How is monthly pricing determined?
Monthly fees are scaled to your annual claim volume and organization size. We tier pricing so smaller health plans, TPAs, and managed care organizations pay proportionally less than enterprise payers — but everyone receives the same complete edit library, the same updates, and the same support.
Are there contingency or savings-based fees?
No. Unlike many competitors, Pilot does not take a percentage of the savings or recoveries our edits help you identify. You pay one predictable monthly fee, and you keep 100% of the value the platform produces.
What’s the typical implementation timeline?
Most implementations move from contract signature to production processing within a few weeks, depending on your integration model and internal IT availability. Hosted deployments are typically faster; on-premise deployments depend on your server provisioning schedule.
Can we trial the platform before committing?
Yes. We offer a sample-claims evaluation in which we run a slice of your historical claim data through the edit library and review the results with you. This gives you an objective view of edit hit rates, potential recoveries, and false-positive risk — all before any production commitment.
Can we license individual edit categories instead of the full library?
Our standard model is the full edit library at one flat fee — a deliberate choice that keeps your edit coverage broad as regulations evolve. If you have a specific use case that warrants a narrower scope, contact us to discuss.
Getting Started
To explore pricing for your organization, contact our team with your approximate annual claim volume and your preferred deployment model (on-premise or hosted). We typically respond within one business day and can provide indicative pricing on the initial call — no lengthy procurement process required to get a real answer.