Machine Readable Files (MRFs)
The No Surprises Act (NSA), signed into law in December 2020, seeks to protect patients from surprise medical bills and prohibits balance billing of patients for certain out-of-network care.
In response to the No Surprises Act, BRMS is providing public access to machine readable files for the employer self-insured healthcare plans they administer. A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention. These files follow a specific layout and format defined by Centers for Medicare & Medicaid Services (CMS) that are not meant for a consumer-friendly search of rates, benefits, or cost sharing. The MRFs include in-network negotiated payment rates and historical out-of-network charges for covered items and services, including prescription drugs.
Table of Contents
Per Anthem, the link will allow you to search for your files using your Employer Identification Number (EIN).
- Anthem Out-of-Network
Due to the file size, the file could take multiple hours to a full business day to open.
- Cigna Out-of-Network
- Dignity Health In-Network (Anthem Providers)
- Dignity Health In-Network (Sacramento Facilities)
- Dignity Health In-Network (Bakersfield Facilities)
- Dignity Health In-Network (Central Coast Providers)
- Dignity Health Out-of-Network
- First Choice Health In-Network (separated by state, click on the applicable state below)
- First Choice Health Out-Of-Network
- FirstHealth PPO In-Network (inactive link - pending info from carrier/vendor)
- FirstHealth PPO Out-of-Network
For BRMS groups, please click on the file that has "PPO Clients" listed as the employer.
- MagnaCare Out-of-Network
Optum Transplant Coverage search on keyword "transplant"
Transplantation is a very clinically complex treatment course involving multiple episodes of care occurring over a broad time horizon. Consequently, the cost of a transplant can vary significantly based on the type of transplant, source of the donor organ, complications encountered during recovery, and many other factors. Due to these complexities, we recommend members contact their Optum transplant nurse case manager for a thorough discussion of their case and estimated costs.