April 27, 2022

Supporting Materials Available for Machine-Readable Files

Applies to ASO Groups

The Transparency in Coverage Final Rule requires insurers and group health plans to publish machine-readable files starting July 1, 2022. The files contain in-network rates and out-of-network allowed amounts.

What’s new: Blue Cross and Blue Shield of Oklahoma (BCBSOK) is providing supporting materials on machine-readable files to ASO groups.

What’s next: As we continue to monitor further regulatory developments related to the machine-readable files, the approach below may be subject to change based on any such developments.

Additional information: Below are answers to some frequently asked questions that may assist with accessing the machine-readable files for your group. If you do not find the answer to your question, please contact your BCBSOK representative or account executive.

Q. An Employer Identification Number (EIN) is required to access my group’s sample machine-readable file. How do I find my group’s EIN?
A. The EIN appears on the employer Benefit Program Application (BPA). If you need further assistance finding your EIN, please contact your BCBSOK account executive.

Q. Will the machine-readable files be the same for Fully Insured and Self-insured (ASO) clients?
A. BCBSOK will follow the standard schema for standard Fully Insured plans. The pricing data and format will be consistent and based on the plan. If the same network and negotiated rates apply, then the files will be the same.