The Transparency in Coverage Final Rules issued by the Centers for Medicare & Medicaid Services, require certain group health plans to disclose on a public website information regarding in-network provider rates and historical out-of-network allowed amounts and billed charges for covered items and services in two separate machine-readable files (MRFs). The MRFs may require a software application to open the document(s). Below the table is a list of software applications that may be used. The MRFs for the benefit package options under CommonSpirit Health’s and Dignity Health’s self-funded and fully-insured medical plans are linked below:
Dignity Health affiliates
If you are enrolled in a medical plan administered by:
- Anthem Blue Cross
- Enter the Dignity Health EIN/TIN - 941196203
- Blue Shield of CA
- Enter 1146-1003 for Bakersfield Access+ HMO R
- Enter 1232-1003 for Bakersfield TRIO HMO
- BRMS
- Dignity Health Central Coast EPOs: Dignity Health In-Network (Central Coast Providers)
- DHMP Ventura EPOs: Dignity Health In-Network (Anthem Providers)
- Enter the Dignity Health EIN/TIN - 941196203
- Dignity Health Ventura PPO: Dignity Health In-Network (Anthem Providers)
- Enter the Dignity Health EIN/TIN - 941196203
- Health Plans of Nevada (HPN)
- For the HPN HMO A-5 and HPN Premier: select: Health-Plan-of-Nevada-Inc_HPN-NV---Grp-HMO_allowed-amounts.json
- For access to information for Providers outside of Nevada, select: UnitedHealthcare-Insurance-Company_UHC-Choice-Plus_in-network-rates.json
- UMR
- Western Health Advantage (WHA)
CommonSpirit Health affiliates
If you are enrolled in a medical plan administered by:
- BCBSIL
- Blue-Cross-and-Blue-Shield-of-Illinois_470617373_Index
- BCBSNE
- BlueCross BlueShield Nebraska - Machine Readable Files (MRFs) (healthsparq.com)
- BlueAdvantage Administrators of Arkansas
- BlueAdvantage
- HealthComp
- Wellmark
Virginia Mason Medical Center 501
If you are enrolled in a medical plan administered by:
- First Choice
- Virginia Mason
The documents are best displayed by using one of the below file extractor software applications. Some of the below software may need you to obtain a license to use the software. Please note that CommonSpirit Health and its affiliates will not be liable for your choice of software to extract the files. These applications may require specific permission of an employer to run on its devices. However, you are free to choose to download a particular software application to your personal device.
Additional information
The Consolidated Appropriations Act of 2021 was enacted on December 27, 2020 and contains many provisions to help protect consumers from surprise bills, including the No Surprises Act under title I and Transparency under title II. The No Surprises Act Notice below outlines the protections available to consumers.