Machine-Readable File Link and Information
June 30, 2022
In November 2020, the Department of Health and Human Services, the Department of Labor and the Department of the Treasury finalized the Transparency in Coverage rule. It requires health insurance carriers to publicly post machine-readable files (MRFs) on a monthly basis by July 1, 2022, that show:
- In-network negotiated rates for covered medical services between the insurer and in-network providers.
- Allowed amounts from out-of-network providers based on charges from a 90-day lookback period.
The following link leads to the machine-readable files that are made available on BlueCross BlueShield of South Carolina's website. The machine-readable files are formatted to allow researchers, regulators and application developers to access and analyze data more easily.
Our website will allow users to search for MRFs by the employer’s IRS employer identification number (EIN) or Health Insurance Oversight System (HIOS) ID. The search will return all relevant files for the employer based on the EIN or HIOS ID and network code.
The easiest way for members to find pricing information remains the Find Care link on My Health Toolkit®. This searchable option is member-friendly and provides the estimated cost and real-time member liability for a variety of services.
You will not be able to retrieve files until July 1, 2022.
Please contact your marketing representative for more information.