TRANSPARENCY IN COVERAGE

Transparency in Coverage rules require health plans to disclose via machine-readable files (MRFs) on a public website information regarding in-network provider rates for covered items/services and out-of-network allowed amounts and billed charges for covered items/services.

The link at  https://lucenthealth.com/transparency-in-coverage/ will lead to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine readable files are formatted to allow researchers, regulators and application developers to more easily access and analyze data.

While these files are accessible to all, the file itself is large, written in JSON, which is a machine-readable language, and not easily interpreted or searchable.