“improving price and quality transparency in American healthcare”
Transparency in Coverage Rule
The link provided below leads to machine readable files (MRFs) that are made available in response to the federal Transparency in Coverage (TiC) Final Rule. The MRFs are created and published by our carrier and third party administrators (TPAs) and include negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers.
It should be noted that these files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. These files are not intended for direct member use. Members should refer to their health plan coverage materials, or use their health plan’s online tools and provider directory to learn about their benefits, medications, and providers.