Beginning July 1, 2022, we will make machine-readable files (MRFs), for plans we administer and maintain, available to the public. The files will contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers. Transparency in Coverage (TIC) regulations require us to make these files available on an open access website effective July 1. A similar requirement for pharmacy data has been delayed.
A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention. They are not meant for use by members. Members can use the Find Care function on our website or SydneySM Health to compare care options.
Your clients can place a link on their public website that leads to the files posted on our site to fulfill their group health plan posting requirement.
We’re sending an email (upstate / downstate) to your clients to let them know about this change.
Please contact your sales representative for more information.