Transparency in Coverage
The Transparency in Coverage rules requires insurance carriers (for fully-insured health plans) and employers (for self-insured plans) to post information about the cost to participants, beneficiaries, and enrollees for in-network and out-of-network healthcare services through machine-readable files (MRF) on a public website. This information 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 access and analyze data more easily.
The following links lead to the Medical (Aetna) and Behavioral Health (Carolina Behavioral Health Alliance) carriers machine-readable files: