PAYERS NEXT UP FOR PRICE TRANSPARENCY DISCLOSURE
BECOME FULLY COMPLIANT WITH CMS TRANSPARENCY IN COVERAGE RULE AND GIVE AWAY A SIMPLE BROWSING EXPERIENCE TO YOUR MEMBERS
Transparency in Coverage Rule Requirements
Health Plans are required to publicly post negotiated rates with in-networks providers.
Disclose billed charges and allowed amounts paid to out-of-network providers.
Negotiated rate for prescriptions drugs.
Requirements Timeline
January 01, 2022
- Disclose and display in a Machine-Readable File
- In-network service file
- Out of network allowed amounts file
- Prescription drugs file
January 01, 2023
Consumer-friendly tool for 500 specified services.
January 01, 2024
Consumer-friendly tool for all items and services.
STAIRS COMPLIANCE SOLUTION
CONSUMER-FRIENDLY TOOL
A custom price transparency website includes data storage, management and publishing in one platform.
Machine-readable file
CMS preferred machine-readable file format with every data element requirement.
EOBs
Produce and manage EOBs.