Transparency
- Blackhawk and the Transparency in Coverage Rule Act: An Overview
- Blackhawk Claims Service, as your health plan administrator, will guide your organization through the Transparency in Coverage Rule Act.
- What is the Transparency in Coverage Rule Act?
- The act requires health insurance issuers and group health plans to make information publicly available.
- The purpose is to help consumers make informed decisions regarding their healthcare.
- How can I access the information?
- Information on in-network rates, out-of-network allowed amounts, and billed charges will be available through Machine Readable Files (MRFs).
- MRFs are extremely large and not user-friendly.
- Blackhawk will publish MRFs on its website monthly.
- Please note:
- Fully Insured Plans: Employers with fully insured plans can expect the insurance carrier to satisfy the act.
- Self-Insured Plans: Employers with self-insured plans should post a publicly available link on their company website to satisfy the act.
- For your convenience, here is a copy of the Transparency in Coverage Rule Act:
https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CMS-Transparency-in-Coverage-9915F.pdf