Transparency in Coverage: Unlocking Clear, Accessible Pricing for All
Empowering Customers with the Healthcare Data They Deserve
Advancing Smarter Healthcare Choices
What is Transparency in Coverage?
The Transparency in Coverage (TiC) rule requires healthcare plans and issuers to disclose price and cost-sharing information to plan participants, beneficiaries, and enrollees.
Specifically, the ruling demands real-time, personalized access to cost-sharing information through digital, internet-based self-service tools — empowering customers with the data they need to make better-informed decisions about their care. (Since July 2022, this data must also be available in machine-readable files [MRFs]).
In addition, the ruling required that plans and issuers disclose the following on a public website:
- In-network negotiated rates
- Billed charges and allowed amounts paid for out-of-network (OON) providers
- Negotiated rates and historical net prices for prescription drugs
The Transparency in Coverage regulations are part of a larger effort by the U.S. federal government to improve healthcare pricing transparency, an initiative also supported by the No Surprises Act.
The goal: Drive innovation; support informed, price-conscious decision-making; and promote competition in the healthcare industry.
Stay Compliant with Expert Guidance
How Vālenz Health® Ensures TiC Compliance
Vālenz Health® provides full transparency into the healthcare process, using extensive cost, quality, and utilization datasets to improve provider selection and decision making — and to ensure Transparency in Coverage compliance for all of our clients.
From cost and quality navigation to out-of-network claims processing and payment, we enable full compliance through every step of the healthcare journey.
Your Solution to TiC Requirements
Valenz Bluebook Comply:
An All-in-One Tool for TiC Compliance
Valenz Bluebook Comply is a comprehensive compliance solution that addresses critical mandates of the Transparency in Coverage rule, including an intuitive price comparison tool, personalized out-of-pocket cost estimates, and MRFs.
Built by industry experts who are actively involved with federal legislators and policy makers, Comply is more than just a checklist; it’s a strategic addition to your benefits strategy that delivers enhanced value beyond simple compliance.
Delivering Smarter, Better, Faster Healthcare
Improve Transparency and Care Outcomes with Vālenz Health®
Stay compliant with Transparency in Coverage regulations — and optimize the entire healthcare journey — with our connected solutions suite.
Secure TiC Compliance Today
Your Journey with Vālenz Health® Starts Here
Connect with a Valenz team member and explore the difference our solutions can make for you.