MRF Engine Accelerate CMS Compliance Coverage Transparency


MRF Engine Accelerate CMS Compliance Coverage Transparency


Accelerate CMS compliance and improve member experience with coverage price transparency

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