CareCost CareCost EstimateBeta
Log in

Editorial Policy

Last updated: May 2, 2026

Why this page exists. CareCost Estimate publishes billing-and-coding references that healthcare providers rely on to bill drugs correctly and to estimate patient out-of-pocket cost. The work has real consequences — denied claims, missed reimbursement, patient surprise bills — so the standards we hold ourselves to are documented here in plain English. This page describes who writes our content, who reviews it, what sources we accept, how we handle disagreements between sources, and how we correct errors when we find them.

1. Who writes and reviews our content

CareCost Estimate's reference content (drug-and-coding pages, methodology notes, billing guidance) is written by the CareCost editorial team and reviewed by a named subject-matter expert before publication. Our named reviewer is Catherine Rose, CPC, a working corporate trainer in revenue-cycle and billing operations who has been retained as an expert witness on medical-billing matters. Reviewed pages carry a visible "Reviewed by" byline, a "Last reviewed" date, and a link back to her profile.

We do not publish anonymous bylines on technical reference content. If a page is unattributed, it has not been put through expert review and is not held to the standards described here; such pages are clearly marked.

2. Source-conflict hierarchy

When two or more sources disagree on a fact, the earlier source in this list wins:

  1. Federal regulation in force. Statutes, regulations, and current Federal Register publications.
  2. CMS authoritative file. The currently effective ASP Pricing File, NDC-HCPCS Crosswalk, HCPCS long descriptor, or Physician Fee Schedule Look-Up record.
  3. FDA-published label. The current Structured Product Labeling (SPL) record retrieved from openFDA, used for indication, dose, formulation, and route.
  4. Payer Transparency-in-Coverage Machine-Readable File. Negotiated rates published under 45 CFR Part 147 where the contract sample meets our minimum threshold for the drug, state, and payer.
  5. Manufacturer-published program page. For copay programs, eligibility rules, and annual benefit maxima.
  6. Foundation-published page. For disease-fund eligibility, covered-drug lists, and open/closed/waitlist status.
  7. Trade aggregators and secondary references. Used as cross-checks, never as the sole source for a published value.

When a higher-tier source is silent, we fall through to the next tier and label the result accordingly on the page (e.g., "ASP fallback: no MRF rate available at sample threshold"). The full version of this hierarchy, including how it shapes calculations, is in the Methodology.

3. Review cadence and dating

Every reviewed page carries a "Last reviewed" date. We do not show a "Last reviewed" date that has not actually been reviewed.

TriggerWhat we do
New CMS ASP quarter published Pricing fields refresh; affected drug pages re-reviewed and re-dated within the quarter.
FDA label change for a covered drug Indication, dose, route, and formulation fields re-checked; page re-reviewed and re-dated.
HCPCS code addition, deletion, or revision Crosswalks rebuilt; affected pages re-reviewed and re-dated.
Foundation status change (open/closed/waitlist) Status field updated automatically; user-facing label refreshed within 24 hours of detection.
Reader-reported correction Triaged within two business days; if confirmed, fix shipped and recorded in the change log.
No external trigger Each reviewed page receives at minimum an annual editorial re-review even if no source has changed.

4. Corrections policy

When we publish something inaccurate, we say so. Our public Corrections & Changelog records every material change to a published page: what was wrong, what is now correct, when the change shipped, and (where applicable) the source that drove the change. We do not silently overwrite reference values. Trivial typo fixes are exempt; anything that would change a biller's coding decision, a reimbursement number, or a patient's out-of-pocket estimate is logged.

To report an error, email editorial@carecostestimate.com. Reports are routed to our named reviewer for assessment. Confirmed corrections normally ship within five business days; corrections that affect a billing or coding decision in current use are prioritized.

5. Use of artificial intelligence

We use AI tools to draft, summarize, and cross-check content. AI-drafted material is not published unless reviewed and signed off by a human editor, and reference content is additionally reviewed by our named subject-matter expert. We do not auto-publish AI output to live reference pages. Where a page surfaces a derived field that an AI helped construct (for example, a plain-language summary of a payer policy), the underlying source is cited so that the reader can verify the original.

We do not use AI to generate factual claims that are not present in a cited source. Specifically, we do not generate fabricated coding examples, hypothetical payer policies, or invented eligibility rules.

6. Conflicts of interest and independence

CareCost Estimate's revenue comes from healthcare providers (medical practices and infusion centers) who pay for the Service. We do not accept compensation, free placement, sponsorship, or favorable-framing agreements from drug manufacturers, payers, pharmacy benefit managers, or patient-assistance foundations whose programs are surfaced in our tools. The order in which programs are surfaced to a user is determined by drug-, diagnosis-, and benefit-eligibility match alone — never by a paid arrangement.

If we ever accept any form of paid placement or sponsored content, this page and any affected page will be updated to disclose it before publication. As of the date above, no such arrangement exists.

Our named reviewer's employment and any disclosures are listed on her profile page.

7. Scope — what this site is and is not

CareCost Estimate is an informational reference and a calculator for licensed healthcare professionals. It is not a source of medical advice, financial advice, legal advice, reimbursement guarantees, claim-adjudication outputs, or coverage determinations. The full statement of what the Service is and is not, and the regulatory framing, is in the Methodology.

For consumer health and financial questions outside the professional billing context, we will tell readers to seek licensed advice from a clinician, financial counselor, patient-advocacy organization, or licensed insurance professional, as appropriate.

8. Reader feedback

Editorial questions, corrections, and source suggestions: editorial@carecostestimate.com.

Product issues and account questions: support@carecostestimate.com.

Compliance and regulatory inquiries: legal@carecostestimate.com.

CareCost Estimate

Specialty drug copay estimation for infusion centers and practices.

Product
  • Features
  • Savings
  • Modifiers
  • Pricing
  • Demo
  • Log In
  • Sign Up
Trust
  • About
  • SME: Catherine Rose
  • Methodology
  • Editorial Policy
  • Corrections
  • Advertising
Legal
  • Privacy Policy
  • Terms of Service
  • HIPAA Compliance
  • Contact
© 2026 CareCost. All rights reserved. Built for specialty practices