Machine Readable Files
Machine Readable Files contain information required by federal regulations and apply to certain types of health plans or issuers. These files, often called “MRFs,” are updated monthly and formatted in accordance with federal standards. MRFs are intended to promote transparency, and are one of several different types places to obtain information on costs.
Although the list below is not exhaustive, it is offered as a courtesy for locations where MRFs for your health plan or coverage may be located. In some instances, different entities may have MRFs because they perform different services for your health plan. For example, provider networks, third party administrators (like AmeriBen), and/or pharmacy benefit managers may be involved.
Under the federal regulations, an in-network and separate out-of-network (also called “allowed amount”) MRF are required to be posted on a publicly available website for certain health plans or issuers when the plan begins or renews in year 2022. Currently, the federal government has deferred enforcement on pharmacy machine readable file pending further rulemaking.
- Per Cigna, “This link leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and 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 more easily access and analyze data.”
- Data iSight
- Blue Cross Blue Shield of Illinois
- Link to access: https://bcbsil.com/asomrf?EIN=123456789
- Copy the above URL, paste it into the browser, and replace the language in red with the employer’s EIN to come to the landing page where file(s) are located.
- HMA Networks (AMN, RAN, HMN)
- HST Medicare-Based Pricing
- MultiPlan, Beech Street, IHP
- Negotiation Services
- Magellan Health