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Birmingham
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Phoenix
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Tucson
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Contra Costa
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Online Lookup - American Speciality Health
Contra Costa
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Denver
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Dolores and San Juan Counties
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Summit County
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Palm Beach
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Pensacola, Jacksonville
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Miami-Dade and Broward Counties
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Treasure Coast
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Daytona Beach, Orlando
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Tampa
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Fort Lauderdale (Standard)
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Fort Lauderdale (Super)
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Sarasota
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Atlanta
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Savannah
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Chicago
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Omaha
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Statewide
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Asheville
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Charlotte
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Greensboro
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Greenville
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Raleigh-Durham
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Winston-Salem
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Oklahoma City
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Anderson & Greenville
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Charleston
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Greenville & Spartanburg
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Myrtle Beach
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Memphis
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Chattanooga
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Nashville
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Columbia and Dickson
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Knoxville
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Livingston and Cookeville
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Dallas (Super)
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Dallas (Standard)
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Dallas (Super)
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Dallas (Standard)
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Hospital Based Providers
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Houston (Super)
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Hospital Based Providers
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Houston (Standard)
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Houston (Super)
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Houston (Standard)
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Hospital Based Providers
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Austin (Standard)
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Hospital Based Providers
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Austin (Standard)
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Salt Lake City
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Northern VA
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Richmond
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Employer
Phoenix
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Tucson
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Denver
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Omaha
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Statewide
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Raleigh-Durham
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Greensboro
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Greenville
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Memphis
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Nashville
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Medicare Advantage
Phoenix and Tucson
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Greater Denver Area
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Formulary 2022 Adult Vision Directory
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Fort Lauderdale and Palm Beach
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Miami-Dade and Broward Counties
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Daytona, Orlando, Southwest
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Central Florida
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Chicago
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New York
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Transparency in Coverage - Machine Readable Files
The Departments of the Treasury, Labor, and Health and Human Services issued the Transparency in Coverage final rules (85 FR 72158) which requires health plans in the individual and group markets to disclose certain pricing information. Under these final rules, plans must publicly disclose in-network negotiated rates and billed out-of-network allowed amounts through two machine-readable files posted on an internet website for policy years beginning in 2022.
Bright HealthCare will make updated files available on a monthly basis. Pricing included in the fee schedule data is accurate as of the date it is extracted but may be subject to change between extraction and the monthly file update. This file, and the included pricing data, is not a guarantee of payment and may not always reflect amounts on final claims processing documentation. Eligibility and benefit determinations are made at the time a claim is adjudicated. Rates for codes appearing in the file may also vary from actual reimbursement amounts when a rate has a modifier applied. Please note that not all information is available at this time. Bright HealthCare is diligently working to publish all required information in a readily translatable form, and we will continue to improve the data we publish. We’re sorry for any inconvenience.
Bright HealthCare Price Transparency Files conform to the standards defined in the CMS technical implementation guide: https://github.com/CMSgov/price-transparency-guide
2022-10-24_EVH_BRIF_P_OON_index.json.zip
2022-10-24_EVH_BRIF_P_OON.json.zip
2022-10-19_valbrif-root_index.zip
2022-10-19_valbrif-root_6eb5a60e-d130-4798-82cc-b37aa6e2ef80_in-network-rates.zip
2022-11-12_Beacon_BRIGHT-HEALTH-PLAN_in-network-rates.json.zip
2022-11-12_Beacon_BRIGHT-HEALTH-PLAN_allowed-amounts.json.zip
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View additional Medicare Advantage forms, documents & directories such as supplemental benefits, information on appointing a prepresentative, and prescription drug coverage.