The Transparency in Coverage Final Rules and related sub-regulatory guidance require most group health plans to disclose on a public website information about the costs of covered items and services in their plans.
This information includes:
- The in-network provider rates for covered items and services (see “in-network-rates”); and
- The historical out-of-network allowed amounts and billed charges for covered items and services (see “allowed-amounts”).
This information is provided in two separate machine-readable files (MRFs).
The files must also include:
- Plan option/coverage identifier information.
- Billing codes to identify items and services for claims processing.
- All applicable rates.
The MRFs are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
The MRFs for the benefit package options under the The Children’s Mercy Hospital Take Care Benefits Plan as included on the governing ERISA plan document and related Form 5500 are available online:
View the Machine-Readable Files
Please note: these files are extremely large and may exceed your network limits. Please consider your network and computer limits before downloading.