MACHINE READABLE FILES
As part of the Transparency in Coverage Final Rule set forth by the U.S. Department of the Treasury, the U.S. Department of Labor, and the U.S. Department of Health and Human Services, group health plans are required to make available to Fund participants negotiated rates for all covered items with in-network providers, and historical payments to and billed charges from, out-of-network providers through machine-readable files (MRFs). These files will allow participants to have access to health plan payment information that can be used to understand health plan pricing and the cost for health care services.
The files that are posted will include:
- In-network provider negotiated rate files
- Out-of-network provider historic allowed amount files
- Table of Contents files
You can look up the files on the attached link: https://www.anthem.com/ca/machine-readable-file/search/ Search EIN 30-0217152 to view files.
PLEASE BE ADVISED THAT THESE FILES CAN BE VERY LARGE AND DEPENDING ON YOUR COMPUTER CAN TAKE LONG TO DOWNLOAD.