Federal Transparency in Coverage (TIC): Machine Readable Files

Network-Specific Transparency in Coverage Machine Readable Files

Federal Transparency in Coverage (TIC) regulations require group health plans to make publicly available machine readable files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers. These regulations call for making these files publicly available with an open access website effective July 1, 2022.

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 further processing without human intervention. These files follow the Centers for Medicare & Medicaid Services (CMS) defined layouts and are in the CMS approved format(s) (like XML or JSON). These files are not meant to be a consumer-friendly search of rates, benefits, or cost sharing which is intended to come later.

SISCO has worked with the PPO Network or vendor providing claim pricing arrangements to display this data. Some of these links may take you to external sites, and the links can be very very large files.

Machine Readable Data files for CIGNA:

Please note: These data files are provided by the PPO Network or pricing organizations listed above. SISCO Benefits is acting as an agent to assist in the delivery of this data to our mutual clients on behalf of these organizations, and as such are not responsible for the content or compliance status of these files. These organizations may provide additional documentation on the data or formats included in the data files.

Questions regarding the naming conventions, files, formats or the content therein should be directed to the repricing entities.

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