Price Transparency

Price Transparency: MRFs and Cost Estimator Tool

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MRFs deadline:

July 1, 2021

Requirements:

In-network negotiated rates

Historical out of network allowed amounts & billed charges

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Cost Estimator Tool deadline:

January 1, 2022

Requirements:

Self-service member tools to facilitate searches

Member access to their accumulator information

What are the biggest challenges?

While vendors support MRFs, the process is complicated by direct contracts, Reference-Based Prices (RBPs), tiered network design, and out-of-network providers.

How do I combine complicated data from multiple networks?

What are the technical requirements for hosting my files?

How much of the costs should be passed through to plan sponsors?

How do I handle third-parties who are late on providing their MRFs?

How do I proceed if CMS hasn’t responded to my technical question?

What does best effort need to look like? How do I host a consolidated MRF? Do I need a cost estimator ideally from one source leveraging MRF?

Comply confidently with our MRF solution!

We understand your pain points:

Expensive setup fees
Resources constraints
Multiple sources of data
Uncertain pricing strategies

Our solution navigates all challenges associated with MRFs, including:

aggregating,
consolidating,
hosting,
disseminating, and
mapping MRFs.

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HubSpot Video

Introducing the zConnect Cost Estimator Tool Solution

A dynamic embedded multi-touch mobile provider search tool configurable to any plan design and network design.

zConnect allows members to search and compare the prices for healthcare services at different places of care based on contracted network negotiated rates

Fully Compliant with Transparency in Coverage law from 2022-2024 & beyond
Allows Patients to view their cost sharing responsibility for care and OOP & deductibles.

 

Watch the attached snippet to learn more about how to tackle the problem!

Master MRFs and price transparency tools through our webinars!

Delve into the snippets from our recent webinar with Mike Orth from LaunchPad Health to begin breaking through MRF complexity and curating a personalised roadmap on price transparency.

 

Learn best practices for tackling challenges associated with MRFs 

Understand strategies for combining data from multiple networks to ensure compliance

Discover how to leverage transparency compliance to deliver long-term advantages.

HubSpot Video
HubSpot Video

Here's what others have to say about zConnect

"The newly launched zConnect cost estimator solution will now be able to satisfy the recent price transparency laws as our groups and members navigate this new phase of healthcare delivery. The zConnect cost estimator solution meets our groups requirements in adhering to both the No Surprises Act and Transparency in Coverage laws. The experience for our members will continue to be simplified, by now displaying dynamic healthcare pricing data.

The zConnect cost estimator solution is an integral piece of the ValueHealth Benefit Administrators mission to simplify the member experience in healthcare and deliver robust plan savings to our customers."

dallas

Dallas Scrip

CEO, ValueHealth Benefit Administrators

"EGP is committed to providing our clients with superior customer service to help them access affordable high quality healthcare.  Providing members with real time healthcare pricing information through a mobile application is a critical step forward towards consumer empowerment in healthcare. The newly launched zConnect price transparency solution is going to play a significant role for our business as a TPA and will assist our clients in achieving regulatory compliance with the upcoming price transparency laws."

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Ken Uveges

President EGP, Executive VP Blue Water Benefits Administration