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PRICE TRANSPARENCY SOLUTION FOR HEALTH PLANS

Achieve price transparency compliance

Ensure your plan stays ahead of the complex and ever-changing Transparency in Coverage mandates with solutions that exceed requirements and delivers an engaging cost experience.

/ THE BEST PAYER PRICE TRANSPARENCY TOOL

Lead the way on price transparency

Evolving price transparency mandates mean that health plans have had a lot to comply with. Not only are there a detailed series of required components, from cost-sharing liability estimates to negotiated rates, out-of-network amounts, and more, but plans must also provide members with an intuitive and engaging cost experience. Kyruus Health’s price transparency solution supports your health plan’s ability to meet—and exceed—ever-changing regulations, and go beyond what is required to offer members a best-in-class cost estimation experience.

Price Transparency Compliance for Health Plans

/ GO BEYOND COMPLIANCE MANDATES

Meeting price transparency requirements has never been simpler

Comply with the latest regulations

Ensure your plan can not only meet changing government regulations—but exceed them.

Self-service made easy

Offers members the most robust self-service tool that adjusts in real-time to provide personalized information.

Make searching simple

Ensure all billing codes are accompanied by comprehensive plain language text descriptions.

Seamlessly offer information

Support transparency initiatives with machine-readable files, a fully configurable print-ready directory, and a self-service experience.

/ PAYER PRICE TRANSPARENCY MADE SIMPLE

Set your plan apart with a tailored experience

Deliver more than your competition

Go beyond what’s required with solutions that guide members to the most appropriate care, helps reward selection of cost-effective, quality providers, and provides meaningful information around complex care.

Offer personalized pricing experiences

Leverage real-time member benefit and deductible status information to deliver accurate, individualized pricing information all the way down to the item and services level.

Make costs searchable in every which-way

Ensure your price transparency tool is easy-to-use and supports searching in any member-preferred way: by provider name, billing code, keyword, geographic proximity, and more.

Check the box on all aspects of requirements

We’ll help you simplify creation of comprehensive machine-readable files, to ensure compliance and access.

FAQs

How do price transparency solutions ensure the accuracy of cost estimates?

Price transparency solutions pull from a health plan’s data, including contracted rates, benefit structures, and historical claims data, to produce accurate cost estimates. Because pricing, benefits, and provider networks can change, these platforms regularly update their information to ensure that estimates reflect the most current and accurate data available.

What types of price estimates can these solutions provide to members?

These solutions can provide estimates for a wide range of healthcare services, including routine and complex procedures as well as help plan for out-of-pocket expenses. Members can often compare costs across different in-network providers or facilities, as well as between in-network and out-of-network options. The estimates are personalized based on each member’s benefits, coverage status, and plan design.

Can price transparency solutions integrate with our existing claims and benefits systems?

Price transparency solutions are designed to leverage data from various healthcare systems, including claims processing, benefits administration, and member portals. By leveraging data from these sources, the solutions can deliver members accurate, personalized cost estimates.

How do price transparency solutions help members compare healthcare costs effectively?

Price transparency solutions help members find and compare healthcare costs, which can vary by location or provider. Members can conduct side-by-side comparisons to identify the most cost-effective option based on their specific benefits and plan details. Price transparency solutions often include filtering and sorting capabilities, allowing members to incorporate other important criteria, such as location or appointment availability, to find the provider that best meets their needs.

What are the key regulatory requirements that price transparency solutions help us meet?

Search and cost solutions help health plans comply with mandates such as the Transparency in Coverage Rule, which requires providing members with access to accurate, real-time cost information. They also support compliance with the No Surprises Act by helping facilitate clear, upfront communication about expected costs and supporting advanced explanation of benefits (AEOB) workflows. In addition, these solutions help plans stay aligned with various state and federal regulations related to price transparency.

How do these solutions personalize cost information based on individual member benefits?

Advanced solutions can access member-specific benefits, deductibles, and out-of-pocket maximums to generate personalized cost estimates. This ensures that members receive accurate information tailored to their unique plan. In addition, some members may be offered rewards or incentives for choosing lower-cost, higher-quality care options.

What reporting and analytics capabilities are included in price transparency solutions?

Price transparency solutions provide detailed reports on member utilization, search trends and more. These analytics enable health plans to monitor member engagement, identify areas for member education and demonstrate the value of their transparency initiatives.

What are the benefits of implementing a price transparency solution for member satisfaction and engagement?

Implementing a price transparency solution boosts member satisfaction by providing clear, personalized cost estimates based on real-time benefits and deductible status. This empowers members to take control of their care journey and make more informed decisions. The intuitive interface and comparison tools further enhance engagement by simplifying the process of finding the most cost-effective care options.

Learn how Kyruus Connect for Payers can protect your plan and engage your members

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