Transparency in Coverage Final Rule CMS-9915-F
Accurate provider data is more important than ever. On October 29, 2020, the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury released the final version of the Transparency in Coverage Final Rule. The rule requires most private health plans (self-insured, ERISA), including group health plans and health insurance issuers to publicly disclose the rates they pay healthcare providers for specific services. Although the rule is designed to provide consumers information about healthcare costs, it indirectly requires health plans to maintain an accurate public provider directory.
The Price Transparency Final Rule brief summarizes the key highlights of the rule and the strategies we’re discussing with our health plan partners.
The brief has been updated with the latest announcements as of October 13, 2021.
Surprise Billing Provider Directory Accuracy Resources
Quest Analytics is your one-stop shop to help you prepare for the new Provider Directory Information and Provider Requirements, listed in the No Surprises Act – Protecting Patients and Improving the Accuracy of the Provider Directory Information. Explore our No Surprises Act Resource Center to stay up-to-date on the provider directory verification requirements, find preparation guides and videos to help you develop a strategic plan to meet deadlines, and learn about the solutions that can get you there quickly.
Deliver on tomorrow's goals by planning today
We are committed to assisting our customers in their quest for accurate provider directories and adequate health networks that maintain appropriate access to care for your members.