The recent Transparency in Coverage Rule marks a monumental shift in health care by requiring health insurance companies to disclose prices to the public. This pricing data is provided through machine-readable files containing the costs of different items and services for providers across the United States. Despite this significant development, the data is still not practically usable by consumers.
Regardless, it's extremely cumbersome, or not possible for even health care providers to confidently determine how insurance companies will calculate the patient's out-of-pocket cost before submitting a claim.To enable consumers to compare prices across providers, insurance companies should be required to provide public APIs to retrieve patient responsibility and eligibility rules given specific procedure codes.
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