To all of our UnitedHealthcare INsiders,

We wanted to share additional information related to the Transparency in Coverage Act and how carriers are planning to help clients. This law was enacted by the Department of Health and Human Services, the Department of Labor, and the Department of Treasury in 2020 (also known as the Tri-Agencies). If you are looking for detailed information on the rulings and regulations, please visit the Fact Sheet that is available on the CMS.

We recommend that the link is posted to your public facing website as soon as possible. Health insurance issuers must publish two separate machine-readable files (MRFs) as follows:

• In Network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers
• Out of Network: Allowed amount paid to, and billed charges from, out-of-network providers for all covered services within a 90-day period 

Read More: https://transparency-in-coverage.uhc.com/

This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.