Insight CMS Price Transparency
Stay compliant with CMS and empower patients with on-demand estimates.
CMS Price Transparency Solution
Generate Cost Estimates & Satisfy CMS Rules
Empower your patients with price transparency. Ensure CMS compliance with confidence.
The Game Has Changed
The CMS Hospital Price Transparency executive order, effective January 2021, requires hospitals to disclose a cost estimate for at least 300 procedures to consumers. The regulation also requires hospitals to post a comprehensive machine-readable file that includes the following standard charges for all hospital items and services: gross charges, discounted cash prices, payer-specific negotiated allowables, and de-identified minimum and maximum negotiated allowables.
New Rules Require New Solutions
CMS continues to raise expectations for Price Transparency, and staying compliant has never been more complex. That’s where Hyve Health shines. Our team of seasoned subject matter experts doesn’t just interpret the rules, we anticipate them.
While the industry waits for CMS to finalize new requirements, Hyve Health stays steps ahead. Our experts analyze emerging guidance, identify patterns, and predict what providers will need to maintain complete and compliant MRFs. This proactive approach ensures your organization is ready long before enforcement begins.
With Hyve Health, you’re not reacting to regulation - you’re leading with confidence. Let our expertise keep you compliant, protected, and ahead of the curve.
Machine Readable Files:
Complete. Credible. Compliant.
As part of your product implementation, Hyve Health builds your Machine-Readable File using a comprehensive and data-driven approach. We leverage your historical 837/835 claims & remit data, contract rates, and chargemaster (CDM) to ensure every value included in your MRF is fully aligned with CMS requirements.
Once your MRF is created, Hyve Health hosts and maintains it for you, eliminating the need for your team to manually upload files or monitor for regulatory changes. Our proactive management allows us to apply updates quickly as CMS guidance evolves, ensuring your MRF remains current, compliant, and ready for audit at all times.
With Hyve Health, your price transparency file isn’t just generated - it’s actively managed by experts dedicated to keeping your organization ahead of every mandate.
Patient Facing Estimation
Using the same data set for your MRF, Hyve Health creates a patient facing estimator tool for your website, allowing on demand patient generated estimates for 300 highly shoppable services specific to your hospital. You stay compliant with CMS and help your patients understand the cost of their healthcare.
The CMS Price Transparency Solution You've Been Waiting For
With Insight™, providers can:
Satisfy Rule CMS–1786–FC.
Satisfy Rule 180.50 – Requirements for making public hospital standard charges for all items and services.
Satisfy Rule 180.60 – Requirements for displaying shoppable services in a consumer-friendly manner.
With Insight™, patients can:
Access via a cloud-based solution through a PC, tablet, or mobile device.
Generate their own estimates.
Understand their healthcare costs.
Revenue Cycle Leader
Louisiana Hospital
Revenue Cycle Leader
Nevada Hospital