Transparency in Coverage Machine Readable File Information:

On November 12, 2020, the Departments of Health and Human Services, Labor, and Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create machine readable files (MRFs) that contain in-network negotiated payment rates and historical allowed amounts and billed charges 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 future processing without human intervention.

The machine-readable files follow the Centers for Medicare and Medicaid Services (CMS) defined layout and are in the CMS approved format.

Medical vendors create and publish the Machine-Readable Files for those benefit plans they administer and are provided on behalf of TLC Benefit Solutions.