July 2022

Pricing Information to Display Starting in July

As we informed you in October, the Transparency in Coverage Final Rule requires health insurers and some employers to publicly display certain health care price information via machine-readable files on their websites beginning July 1, 2022. These machine-readable files will include negotiated rates with in-network providers and allowed amounts for out-of-network providers. The files are in a format required by the Centers for Medicare and Medicaid Services.

What this means for you

• These files will include the place of service (POS) code, your federal Taxpayer Identification Number (TIN) and your National Provider Identifier.

• If you’re using your Social Security number as your TIN, we encourage you to register for a new TIN and update us through our Demographic Change Form.

More on the Consolidated Appropriations Act and Transparency in Coverage Final Rule .

*Group Open Access members may be responsible for cost share for supplemental dental services from non-contracted Medicare providers.

Out-of-network/non-contracted providers are under no obligation to treat Blue Cross Medicare Advantage Flex (PPO) or Blue Cross Group Medicare Advantage Open Access (PPO) members, except in emergency situations.

Verification of eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.

HMO and PPO plans provided by Blue Cross and Blue Shield of Oklahoma, which refers to GHS Health Maintenance Organization, Inc. d/b/a BlueLincs HMO (BlueLincs) (HMO plan) and refers to GHS Insurance Company (GHSIC) (PPO plans). HMO and PPO employer/union group plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HCSC, BlueLincs, and GHSIC are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC, BlueLincs, and GHSIC are Medicare Advantage organizations with a Medicare contract. Enrollment in these plans depends on contract renewal.