Transparency in Coverage Machine Readable Files
To support the Transparency in Coverage final rules, Centene has published machine-readable files (MRFs) for group health plans and individual market issuers in a JSON format. There are two machine readable files, one disclosing in-network negotiated rates and one for out of network allowed amounts.
- Below are links to Table of Contents files for Ambetter, QualChoice, Health Net, MHN, WellCare of North Carolina and Fidelis health plans. These reference the locations from which appropriate machine readable files can be downloaded.
- These files will be updated on a monthly basis.
- Please note these may be very large data files. To download these files, an application designed to handle large data files may be recommended.
- Pricing information may be subject to change between when the file was published and the next monthly update.
For questions, please contact: price_transparency@centene.com
For Members
These are large files that may not be as directly useful for members. Members may want to access their health plan coverage materials instead to learn more about their benefits.
Links to the download TOC files
- Index File for Ambetter Plans
- Index File for Fidelis Plans
- Index File for QualChoice Plans
- Sub-Index QualChoice File for Alf Plan
- Sub-Index QualChoice File for Arnold and Belvins Area
- Sub-Index QualChoice File for Big Four Area
- Sub-Index QualChoice File for City of Fort Smith Area
- Sub-Index QualChoice File for City of Hot Springs Area
- Sub-Index QualChoice File for Dillards Area
- Sub-Index QualChoice File for JV Manufacturing
- Sub-Index QualChoice File for Royal Financial
- Index File for Health Net Plans
- Index File for MHN
- MHN is now included in Ambetter CA for marketplace plans and in Healthnet for commercial plans.
- Index File for WellCare of North Carolina
Centene Employees
These links leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, consumer advocates, and application developers to more easily access and analyze data.