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Beginning July 1, 2022 and over the coming months, colleagues and family members enrolled in a Trinity Health sponsored medical plan will notice several enhancements to help better understand the cost of receiving healthcare. Colleagues will see changes to their medical ID cards, the addition of price comparison tools that use real-time deductible and out-of-pocket totals and will no longer be surprised with balance billing for certain services. These changes will make healthcare costs more transparent and minimize unexpected bills when you seek healthcare services.
Medical Plan ID Cards
The Consolidated Appropriations Act (CAA) requires new and digital medical ID cards be personalized with a member's deductible, out-of-pocket maximum and medical service provider assistance information. Most medical service providers are only printing the new ID cards for new members or if a member requests a new card. You can print the new card format by logging into your medical service provider's website.
Balance Billing
Federal and state laws no longer allow surprise billing for all emergency services including air ambulance and some non-emergency services when provided by an out-of-network provider in an in-network facility. For example, if a medical plan provider has surgery at an in-network hospital, but the anethesiologist is out-of-network, the anethesiologist may not balance bill beyond the in-network cost.
Price Comparison Tools
Beginning Jan. 1, 2023, out-of-pocket maximum and price comparison tools will be available through each medical service provider. The tools will allow members to compare pricing for services with different providers using real-time deductible and out-of-pocket maximum balances. This will give you a more accurate estimate of the cost of the service.
Machine Readable Files
New regulatory requirements under Consolidated Appropriateions Act (CAA) and Payer Transparency (PT) require health plans to make public files containing negotiated rates with in-network providers, allowed amounts and historical billed charges for out-of-network providers.
Aetna Machine Readable Files Click here
BCBSM Machine Readable Files Click here
Excellus Machine Readable Files Click here
Health Choices Machine Readable Files Click here
Trustmark Machine Readable Files Click here
*You will be notified as other components that directly impact colleagues go into effect.