AxsID

Foundation / Payer Truth Set

The relationship master for access. It doesn't just normalize codes; it models the real-world roles between payers, PBMs, plan sponsors, processors/TPAs, specialty networks, GPOs, and assistance programs — and makes that graph consumable at the right grain for both analytics and operational workflows.

What it does

AxsID ingests BIN/PCN/GROUP and medical plans from claims, processor lists, and multiple payer sources; resolves conflicts (one processor per BIN); and ships crosswalks to keep downstream systems stable.

Stakeholder entities mastered

Comprehensive coverage of all access relationship participants

Payer Parent / Holding Group

Parent organizations and holding companies that own multiple payer entities

Payer (Legal Entity)

Legal entity with channel specification (Pharmacy vs Medical)

PBM / Processor

Benefit manager and switch/claims routing processor

Plan Sponsor

Employer/group, government program, or association

TPA / Administrator

Third-party administrator where applicable

Plan / Benefit Program

Option/LOB, metal tier, benefit year specifications

Relationship types captured

Comprehensive relationship modeling for access complexity

owns / parent_of

Payer Parent → Payer

administers / manages_benefit_for

PBM/TPA → Plan Sponsor/Plan

processes_claims_for

Processor → Payer/PBM with effective dating

contracts_with / network_of

Payer/Plan ↔ Specialty Pharmacies

sponsors

Plan Sponsor → Plan/Benefit Program

supports / eligible_for

Assistance Program ↔ Payer/Plan rules context

Granularity controls

Choose the right grain for the job

Routing grain (operational)

Processor + BIN (+ PCN/GROUP when applicable)

Payer grain (analytics)

Canonical Payer ID (channel-specific) with effective-dated parent ownership

Plan grain

Payer + Plan/Benefit Program (+ LOB + Product + Year)

Sponsor grain

Plan Sponsor + Plan with PBM/TPA role links

Network grain

Plan ↔ Specialty Pharmacy relationship (in/out-of-network)

Assistance grain

Plan or Payer rules mapped to copay/PAP eligibility signals