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Price Transparency in Coverage

Machine Readable Files

At UCare, we are dedicated to simplifying health coverage so our members can make the best choices for their health and well-being. That’s why we wholeheartedly believe in the recent Transparency in Coverage Final Rule from The Centers for Medicare & Medicaid Services (CMS). Price transparency provides members with valuable information about health care costs before receiving care, so they can make informed health care decisions.

Currently, CMS requires that all health plans provide price transparency information in two machine readable files. These files will include negotiated rates with in-network providers, allowed amounts for out-of-network providers and may include prescription-drug pricing. In the near future, we look forward to offering a robust web-based price comparison tool. Members will be able to use this tool to receive cost-sharing estimates for items and services.

Call UCare customer service if you have any questions.

Machine Readable Files

In-Network Rate File: rates for all covered items and services between the plan or issuer and in-network providers.

Allowed Amount File: allowed amounts for, and billed charges from, out-of-network providers.