CMS Transparency in Coverage is a mandate that requires payers, including health insurers, to publicly disclose detailed pricing information, including negotiated rates, through machine-readable files. This data allows for more transparency in healthcare costs.
Payers are required to publish negotiated rates with healthcare providers, including in-network and out-of-network rates. The data includes various details about services, codes, and associated pricing for healthcare services, often contained in large files that can reach several gigabytes in size.
Each payer publishes their machine-readable files (MRFs) in different locations. On this page, we've grouped the locations by payer to help you easily access and navigate through these large datasets. The table of contents for each payer’s files is also provided to offer quick access to the files.
The viewer tool available on this page allows you to browse the table of contents for the large MRFs and quickly preview headers of these files, which can help you identify relevant data without having to download and open the entire file.
PayerAnalytics processes the raw data published by payers, extracting the relevant benchmarking information you need. This includes anonymized datasets that are structured for easier interpretation and analysis, helping you compare negotiated rates and make informed decisions.
PayerAnalytics offers additional advanced tools to help you extract and analyze key data from the massive CMS Transparency in Coverage files. These tools are designed to streamline the data extraction process and provide actionable insights for benchmarking healthcare rates and optimizing financial outcomes.
Contact us to learn more about how PayerAnalytics can assist you in processing CMS Transparency in Coverage data. Our team can provide demos and help you integrate our advanced tools into your workflow to ensure compliance and leverage benchmarking data effectively.
Contact us to schedule a demo and see how PayerAnalytics can work for you.