PFM's Machine Readable Files

The federal Transparency in Coverage Rule (TCR) requires health plans and plan sponsors to make in-network and out-of-network Machine Readable Files (MRFs) available to the public by July 1, 2022.

In-Network and Out-of-Network MRFs

Independence Administrators will provide their self-funded customers with a link which will include a Table of Contents unique to that customer. The customer's Table of Contents file will include links based on each set of network rates the customer utilizes and out-of-network allowed amounts specific to the customer. If a self-funded customer has contracted separately with providers/facilities, then those rates will not be included within the files.

The link leads to the machine-readable files which 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.