MRF Engine for Payers Reviews & Product Details

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