Transparency Coverage2024-04-08T08:43:05-05:00

Transparency in Coverage

On July 1, 2022, the Transparency in Coverage (TIC) Rule requires health insurers and group health plans to provide Machine Readable Files (MRFs) for:

 
  • In Network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers
 
  • Out of Network: Allowed amount paid to, and billed charges from, out-of-network providers for all covered services within a 90-day period

A machine readable file (MRF) is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention.

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. https://www.floridablue.com/members/tools-resources/transparency

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