Compliance Resources

7 Articles

• Shoppable Services (Payer)

  Payers are required to publish an online Patient Estimate tool containing 500 shoppable services. Let’s explore what those are, exactly.

• Shoppable Services (Hospital)

  Hospitals must post a total of 300 shoppable services to their website. Of those 300, 70 have been pre-determined. Dive into clarity, here.

• Payer Patient Estimate Tools (PET)

  Required as part of TiC, payers and insurers must disclose cost-sharing info online via a self-service tool we’ve dubbed the Patient Estimate Tool (PET).

• Payer MRF Requirements

  As of July 1, 2022, payers must publish two machine-readable files containing a variety of both in- and out-of-network files. They’re cool, we promise.

• Hospital MRF Requirements

  As of 2021, hospitals must publish a machine-readable file (MRF) containing gross, discounted, cash, and negotiated rates. They love it.

• Price Transparency Compliance Over Time

  Let’s review price transparency compliance rates from 2021 to now.

• State-Level Price Transparency Legislation

  Over the past decade, several states in the U.S. have introduced or passed bills for healthcare price transparency and patient protection. We love to see it.