Transparency in Coverage Rule (TCR) - BCBSKS Machine-readable Files
Machine-readable files are a requirement of the Transparency in Coverage Final Rule.
Health insurers are required to publicly display certain healthcare price information via machine-readable files on our websites. These machine-readable files will include negotiated rates with in-network providers, allowed amounts for out-of-network providers and may include prescription-drug pricing.
CMS requires that machine-readable files (MRF) be posted in the JSON format; specifications are provided at https://github.com/CMSgov/price-transparency-guide.
These files are intended to be used by researchers, regulators and application developers. MRFs are not intended for member or consumer use. In 2023 members should have access to a user-friendly cost calculator tool with pricing information for 500 "shoppable services," as defined by CMS.
The following files are available for use, and will be updated monthly:
- In-Network negotiated rates with providers
- Historical payments to out-of-network providers and their billed charges
Blue Cross and Blue Shield of Kansas takes pride in ensuring our website content is current and compliant with state and federal requirements. However, due to issues beyond our control, some information may be unavailable. In our continuing efforts to offer our customers an extensive nationwide network of providers, we work with multiple Blue Cross and Blue Shield plans across every state. Unfortunately, this means sometimes we are limited in what we can provide by what other plans are able to produce. In this case, some Blue Cross and Blue Shield plans failed to produce all the necessary documentation for the information displayed on this page. We apologize for the inconvenience and will update these details when they are available.