SAN FRANCISCO--(BUSINESS WIRE)--Amino Health, the leading digital healthcare guidance company, today announced new functionality that enables healthcare industry compliance with aspects of the federal Transparency in Coverage (TIC) Rule that take effect January 1, 2023. Amino’s features go beyond compliance, contextualizing mandated cost data in a sleek, intuitive healthcare navigation experience designed to guide plan members to the high-quality providers, facilities, and benefits that maximize cost savings for plan sponsors.
“As advocates for greater transparency in healthcare, at Amino, we’re proud to be among the first to launch Transparency in Coverage functionality,” said Sarah Bimber, general counsel at Amino Health. “We’ve worked closely with external healthcare counsel, current regulators, and former regulators who crafted the TIC rules to ensure that Amino’s TIC functionality meets regulatory requirements and shed light on areas where we hope to see further evolution in the law and available guidance.”
Published in 2020, the regulations require all group health plans and health insurance issuers to disclose price and cost-sharing information via an online, self-service price comparison tool. The tool must give plan members the ability to receive an out-of-pocket cost estimate for different providers for items and services represented by 500 specific Current Procedural Terminology (CPT) billing codes covered by the plan as of the beginning of the plan year starting January 1, 2023. The requirements extend to all covered items and services in 2024.
Amino has publicly championed price transparency for many years. In addition to participating in the rulemaking process for the TIC Rule, Amino advocated on behalf of consumer transparency in connection with earlier Price Transparency for Hospitals regulations, and its leaders have participated in industry and government-led working groups.
“Price transparency isn’t new to us. Since our founding in 2013, the Amino platform has included cost estimates based on insights derived from billions of de-identified data points,” said David Vivero, CEO and founder of Amino Health. “Amino’s Transparency in Coverage functionality is the latest innovation that furthers our ability to equip Americans with the information they need to make informed healthcare decisions for themselves and their loved ones.”
As the only healthcare navigation platform certified by Medicare to develop quality measures that reflect variations in the healthcare system, Amino has been recognized by price transparency regulators as leading the industry towards better patient outcomes.
New Amino platform functionality fulfills regulatory requirements for an online shoppable tool. Health plan members will be able to search for covered items or services, either by name or CPT code. Results include the cost information specific to the member’s health plan and the selected entity or provider, as well as:
- In-network negotiated and out-of-network historical rates
- Remaining deductible
- Copay obligation
- Co-insurance
- Estimated total out-of-pocket cost
Amino designed these new features with the belief that price transparency tools only will 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 that experience, the Amino platform will guide plan members across sectors, industries, and plan types to the highest quality, most cost-effective corners of their networks.
“When we created TIC, we expected that the insurer data would be overwhelming, and that private firms and researchers would step in to do the deep analysis and data production,” said Eric Hargan, former deputy secretary of the Department of Health and Human Services (HHS) and price transparency advisor at Amino Health. “Having helped to architect the Transparency in Coverage Rule, I couldn’t imagine a better example of a company taking our vision and putting it into action.”
To get started with Amino or learn more, visit www.amino.com.
About Amino Health
Amino Health, the leading data-driven healthcare guidance platform, connects people with high-quality, cost-effective providers and benefits programs in context across the healthcare ecosystem. With more than 26B healthcare claims used to inform our actionable healthcare recommendations, Amino Health reduces wasteful claims spending, streamlines care routing, increases care quality, and improves care outcomes for plan sponsors and members. To learn more, visit amino.com.
