Machine-Readable Files
As a requirement of the No Surprises Act and Transparency in Coverage Final Rule set forth by the U.S. Departments the Treasury, Labor, and Health and Human Services (the Departments), group health plans and health insurance issuers are required to post machine-readable files to a publicly available internet website without condition, detailing all negotiated rates for covered items and services with in-network providers, and billed charges and historical payments with out-of-network providers.
These machine-readable files must be updated monthly and are intended to increase transparency in health plan payment information, which can be used to help consumers better understand the costs for health care services.
File Format
Machine-readable files must adhere to a non-proprietary, open standard format, such as JSON, XML or YAML, and be made available on a publicly accessible website without condition, via HTTPS.
The files must be formatted according to the specifications set forth in the technical implementation guidance published by the Centers for Medicare & Medicaid Services (CMS). Price transparency guide
Download Machine-Readable Files
Machine-readable files are posted to sub-domains created for each client individually. If you are interested in learning more about this service please contact Green Light at sales@greenlightcm.com