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.

Beginning July 1, the link at 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.