Beginning in July 2022, Payors and TPA’s will need to comply with the Transparency in Coverage final rule, released by the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury. While all aspects of this rule are ultimately the responsibility of the Payor, Prime Health Services supplies the Network of providers, and therefore will support our payors by providing the in-network file portion of this rule.

Prime Health Services networks are leased by health plans and administrators in a variety of configurations.  We anticipate payor and insurers will incorporate our data into their plan-specific files.  The In-Network Rates file contains information about the negotiated discounts for services provided by in-network healthcare providers. The Provider Reference file provides a comprehensive list of healthcare providers within our network. It includes provider names, addresses, specialties, and other relevant information.

These files are updated regularly to reflect the most current information. By providing these resources, we aim to promote transparency and empower our members with the information they need to make informed healthcare choices