Payer Price Transparency

6 Articles

• Transparency In Coverage Final Rule (TiC)

  As of July 2022, payers must publish two machine-readable files showing specific rates and charges. But wait, there’s more!

• Shoppable Services (Payer)

  Payers are required to publish an online Patient Estimate tool containing 500 shoppable services. Let’s explore what those are, exactly.

• Payer Patient Estimate Tools (PET)

  Required as part of TiC, payers and insurers must disclose cost-sharing info online via a self-service tool we’ve dubbed the Patient Estimate Tool (PET).

• Prescription Drug Price Transparency

  As of now, the prescription drug file requirement is delayed. But, that’s not the end to this story.

• Payer MRF Requirements

  As of July 1, 2022, payers must publish two machine-readable files containing a variety of both in- and out-of-network files. They’re cool, we promise.

• State-Level Price Transparency Legislation

  Over the past decade, several states in the U.S. have introduced or passed bills for healthcare price transparency and patient protection. We love to see it.