Plans must disclose (effective 1/1/2022, enforcement 7/1/2022, but is extended to your renewal date of 11/1/2022): negotiated rates for in-network (INN) covered items and services; historical out-of-network (OON) billed charges and payments for a 90-day period. Required format is machine-readable files that must be updated monthly. Disclosures must be posted on a public website and accessible free of charge and without requiring the establishment of a user account or password.
Because your medical plan is fully-insured, there is not clear guidance on if the carrier posting is sufficient so the most conservative approach would be to post it on your own public website along with the below recommended verbiage.
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.
If you do not have a public website CMS issued a clarification on 6/17/2022 stating that you may enter into an agreement with the carrier/TPA to handle on your behalf, but logistics/formal guidance on this is still pending. Technical Clarification | CMS
Transparency in Coverage DisclosureMediaBeast2022-07-01T18:35:39+00:00