Transparency in coverage for no surprise in medical billing

Transparency in Coverage for Provider Data Management

Transparency on in-network and out-of-network deductibles & out-of-pocket limitations on health insurance coverage ID cards.

Machine-readable files with in-network negotiated rates, out of network average charges and payments, and prescription drug rates.

Provider price transparency and comparison tools that allow patients to understand and compare expected out-of-pocket costs for items and services across multiple providers.

​Individual Disclosure including estimation for shoppable services and patient estimation.

Trust. Access. Cost Control.
A better experience for you and your consumers.

Build consumer trust and loyalty with accurate healthcare cost transparency and comparison tools.
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Improve revenue: Lower claims expenses with the ability to prioritize preferred providers and centers of excellence.

Enable consumer access through the online and mobile provider directory, email, and texts.
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Provide out-of-pocket cost analysis to enable consumers to better control cost and care when "shopping" for healthcare.

Empower consumers to make informed care decisions with transparency in coverage

Enable publicly posted provider pricing information based on negotiated rates for common or shoppable items and services, in an easy-to-understand, machine-readable format.  Perspecta's price transparency solutions allows health plans and providers to post standard charge information for services, supplies, and fees billed by providers to be posted online with monthly data updates.
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The solution is compliant with the price transparency requirements of the No Surprises Act and enables provider price and cost-sharing information for related health care services, including:

1. In-network provider negotiated rates
2. Out-of-network allowable amounts as historical payments and charges
3. In-network negotiated rates for covered drugs and net prices for prescription drugs at pharmacy location level