SAN FRANCISCO–(BUSINESS WIRE)–Amino Health, the leading digital healthcare consultancy, today announced new functionality that will enable the healthcare industry to comply with aspects of the federal Transparency in Coverage (TIC) rule, effective January 1, 2023. Amino’s capabilities go beyond mandated compliance, contextualizing cost data in a sleek, intuitive healthcare navigation experience that guides plan members to the high-quality providers, facilities, and benefits that maximize cost savings for plan sponsors.
“As advocates for greater transparency in healthcare, we at Amino are proud to be among the first to introduce the Transparency in Coverage feature,” said Sarah Bimber, General Counsel at Amino Health. “We have worked closely with external healthcare consultants, current regulators and former regulators who prepared the TIC Rules to ensure that Amino’s TIC functionality meets regulatory requirements and to highlight areas where we are addressing hope for further development of the law and the available guidance. ”
Regulations released in 2020 require all group health insurance plans and health insurers to disclose pricing and co-payment information through an online self-service price comparison tool. The tool must provide plan members with the ability to obtain a quote from various vendors for items and services represented by 500 specific CPT (Current Procedural Terminology) billing codes covered by the plan as of the plan year beginning January 1, 2023. The Requirements extend to all covered items and services in 2024.
Amino has publicly advocated price transparency for many years. In addition to participating in the rulemaking process for the TIC Rule, Amino has advocated on behalf of consumer transparency related to previous hospital price transparency regulations, and its executives have participated in industry- and government-led working groups.
“Price transparency is nothing new for us. Since our inception in 2013, the Amino platform has included cost estimates based on insights from billions of unidentified data points,” said David Vivero, CEO and Founder of Amino Health. “Amino’s Transparency in Coverage feature is the latest innovation that strengthens our ability to empower Americans with the information they need to make informed health decisions for themselves and their loved ones.”
As the only healthcare navigation platform certified by Medicare for developing quality metrics that reflect healthcare system differences, Amino has been recognized by regulators for pricing transparency as an industry leader toward better patient outcomes.
The new functionality of the Amino platform meets the regulatory requirements for an online shopping tool. Health plan members can search for covered items or services by either name or CPT code. Results include cost information specific to the member’s healthcare plan and the facility or provider selected, as well as:
Tariffs negotiated on-network and historical off-network
Estimated total cost out of pocket
Amino developed these new features in the belief that price transparency tools only improve consumer decision-making if members use them. Originally a B2C product, Amino Health has spent years developing a highly engaging product with an intuitive user experience. With new pricing data as part of this experience, the Amino platform will guide plan members to the highest-quality, lowest-cost corners of their networks across sectors, industries, and plan types.
“When we started TIC, we anticipated that the insurer data would be overwhelming and that private firms and researchers would step in to do the in-depth analysis and data production,” said Eric Hargan, former assistant secretary of the Department of Health and Human Services (HHS). and Price Transparency Advisor at Amino Health. “Having helped develop the Cover Transparency Rule, I could not think of a better example of a company taking our vision and making it a reality.”
To get started with Amino or to learn more, visit www.amino.com.
About Amino Health
Amino Health, the leading data-driven healthcare consulting platform, connects people with quality, cost-effective providers and benefit programs in the context of the entire healthcare ecosystem. With more than 26 billion health claims fed into our actionable health recommendations, Amino Health reduces wasteful claims spend, streamlines care planning, increases quality of care, and improves patient outcomes for plan sponsors and members. To learn more, visit amino.com.