Transparency in Coverage Machine Readable Files

To support the Transparency in Coverage final rules, º£½ÇÂÒÂ× has published machine-readable files (MRFs) for group health plans and individual market issuers in a JSON format. There are two machine readable files, one disclosing in-network negotiated rates and one for out of network allowed amounts.

  • Below are links to Table of Contents files for Ambetter, QualChoice, Health Net, MHN, WellCare of North Carolina and Fidelis health plans. These reference the locations from which appropriate machine readable files can be downloaded.Ìý
  • These files will be updated on a monthly basis.
  • Please note these may be very large data files. To download these files, an application designed to handle large data files may be recommended.
  • Pricing information may be subject to change between when the file was published and the next monthly update.

For questions, please contact: price_transparency@centene.com

For Members

These are large files that may not be as directly useful for members. Members may want to access their health plan coverage materials instead to learn more about their benefits.

Links to the download TOC files

º£½ÇÂÒÂ× Employees

These links leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and 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, consumer advocates, and application developers to more easily access and analyze data.