Consolidated Appropriations Act: Transparency In Coverage
This link leads 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.
The link will allow you to search for your files using your Employer Identification Number (EIN), as shown below. When using the search option, the page will display links to several files, including:
- Applicable In-Network Negotiated Rate Files
- Out-of-Network Allowed Amount Files
- Out-of-Area Rates (applicable when members use providers in non-provider states.)