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Sage Transparency in Coverage Machine Readable Files

The Transparency in Coverage Final Rules require non-grandfathered group health plans to disclose on public website information regarding:

  1. The in-network provider rates for covered items and services.
  2. The historical out-of-network allowed amounts and billed charges for covered items and services in two separate machine-readable files (MRFs). 

The files must, in part, also include plan option/coverage identifier information; billing codes to identify items and services for claims processing; and all applicable rates.
The MRFs for the non-grandfathered group health plan(s) in the AETNA & KAISER Plans are linked below: