Machine-readable files with in-network negotiated rates, out of network average charges & payments, & prescription drug rates.
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Price transparency & comparison tools enabling member to understand & compare expected out-of-pocket costs for items & services across multiple providers for 500 shoppable services & EOB. |
Coverage ID cards to show in-network and out-of-network deductibles & out-of-pocket limitations. |
Individual Disclosure including estimation for shoppable services & patient estimation. |
Be preparedStay ahead of the CMS transparency in coverage rulingPlan & prepare for the "No Surprises Act" transparency in coverage rule. Don't be caught by surprise. Understand how this CMS legislation effects your business, consumers, & the healthcare ecosystem overall.
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Breaking down the ruling
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CMS's regulation, the No Surprises Act, creates new guidelines to eliminate “surprise” medical billing & create transparency in coverage.
Simply put, the legislation promotes the idea that patients should not be responsible for out-of-network costs that they did not agree to pay. |
Don't be caught by surprise.
A few key requirements include price transparency, provider directory data accuracy & accessibility, & simplifying the means for consumers to get their questions answered. Learn more in the detailed summary from the American Hospital Association. |
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2022
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2023
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2024
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