References
Transparency in Coverage (TIC) regulations require health insurers and group health plans to create machine readable files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers and make those files publicly available.
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.
These files follow the Centers for Medicare & Medicaid Services (CMS) defined layout and are in the CMS approved format (JSON) and are not meant for a consumer-friendly search of rates, benefits, or cost sharing. Please refer to the member resources available through anthem.com for this information.
Anthem is committed to delivering on meaningful transparency efforts that help consumers make informed healthcare decisions and in supporting the Transparency in Coverage regulations, as outlined by the Tri-Agencies.
The link below will redirect you to Anthem’s portal.
www.anthem.com/machine-readable-file/search
Here, you will have access to such documents as listed below:
- Applicable In-Network Negotiated Rate Files
- Out-of-Network Allowed Amount Files
- Out-of-Area Rates (applicable when members use providers in non-Anthem states.)
Please note: In order to access these documents, you will need to enter the BMT FEIN. If you are unsure of the FEIN, you can find this information on your most recent BMT W2, or contact local HR.