CitiusTech’s Machine-Readable File Engine (MRFE) is a platform agnostic, turnkey SAAS solution that helps payers accelerate CMS compliance for Coverage Transparency, generating machine readable file with in-network negotiated provider rates. This will empower members to make well-informed decisions about procedures and treatment options, based on prices.

Solution Focus: As per CMS Transparency in Coverage Rule, health plans are required to publicly disclose in-network provider-specific reimbursement rates in a machine-readable file. CitiusTech’s MRFE helps health plans generate the mandated in-network file containing payer and provider negotiated coverage rates.

Key Features:

Highly Scalable architecture: Process large volume of data with complex and iterative business rule(s)

Configurable and Modular: Enables ease of customization and enhancement

Auditability and Transparency: Granular and detailed logging & notification framework

MRFE can further enable Health plans with:

Faster implementation of personalized cost estimator tool

Unified view of negotiated rates enabling analytics for value-based payment models

Optimization of provider network management with market insights

Handle schema changes by CMS

Monthly updates to MRF files

Health plans can Improve member experience by providing:

Easier access to costs across in-network providers enabling informed decisions

Increased transparency that will influence competitive pricing and reduce overall costs

MRF Engine Accelerate CMS Compliance Coverage TransparencyCitiusTech

MRF Engine Accelerate CMS Compliance Coverage Transparency

CitiusTech

MRF Engine Accelerate CMS Compliance Coverage Transparency

CitiusTech

MRF Engine Accelerate CMS Compliance Coverage Transparency
CitiusTech