PHILADELPHIA, February 17, 2022 (Newswire.com) - Perspecta, LLC and Transparent Health Marketplace (THM) announced a new collaboration to ensure Health Plans meet the CMS "No Surprises" Act transparency in coverage rule, which went into effect January 2022 with a phased implementation by the end of 2024. The shared goal for the partnership includes a fast-track solution integration to enable customers to meet the complete requirements before the end of 2022, well ahead of the final 2024 requirements.
The provisions of the transparency in coverage rule seek to empower consumers and members to visualize and compare in-network and out-of-network costs between specific providers for any healthcare procedure, offering better insight into the total cost of services before they obtain care. The goal is to eliminate surprises in medical billing.
"For some time, there's been a real need for price transparency in our industry, and the No Surprises Act helps us push that need to the forefront," said Robert C. Mortensen, President and CEO, THM. "We are delighted to collaborate with Perspecta on this solution that allows our clients to comply with the CMS Final Rule by leveraging our collective advanced data and intelligent marketplace technologies. Our solution delivers competitive advantages to our clients by allowing their health plan members, for the first time, to understand their cost of care up front and make more informed decisions."
"We believe it is critical for our customers to take a comprehensive approach to implementing transparency in coverage," Howard Koenig, Perspecta President and CEO said. "Although the regulatory framework involves increasing requirements over the next 2-3 years, Perspecta & THM have constructed a path that not only complies with the CMS rule but also offers a holistic, seamless solution that is driven by our AI & machine-learning powered provider directory - VIIAD."
"The proprietary algorithms within our provider directory intelligently sorts & displays the most cost & outcome effective providers for easy member decision-making," April Stiles, Perspecta COO explained. "As part of the comprehensive transparency in coverage solution, we offer several features that are personalized to answer member questions regarding provider costs, locations, specialties, quality and preferences. Thanks to the power of machine learning, our solution even prioritizes providers who are accepting new patients or offer telemedicine for no surprises in provider data accuracy or medical billing."
The transparency in coverage solution is part of Perspecta's paradigm of reimagining the industry's approach to provider data management. The collective transparency in coverage package demonstrates the innovation of both Perspecta and THM. We expect the partnership will produce accelerated client and revenue growth during 2022 and beyond. These new solutions are powered by our Provider Data Management solutions and proprietary data assets.
About Transparent Health Marketplace, Inc.
Transparent Health Marketplace (THM) Transparent Health Marketplace (THM) operates the first marketplace of its kind to provide real-time price transparency and analytics with the ability to easily shop, book and pay for healthcare services in workers' compensation. The simple, intuitive digital platform automates scheduling, paperwork, and payment processes to give providers more time to deliver quality healthcare to their injured workers. The marketplace delivers increased speed to care, cost savings, growth opportunities, affordable quality healthcare, and can be tailored to individual payor and provider needs.
Perspecta is the leader in provider data management solutions designed to optimize the business of healthcare. Through deep domain expertise and spirit of innovation, Perspecta accelerates the transformation of provider network management, delivering value to our customers and the providers, consumers, and partners they serve. Perspecta's provider data management solutions create a better user experience and significant return on investment for health plans, workers' compensation, and government health plans. Perspecta's clients include four out of five of the largest health insurers, 11 regional carriers, and 10 out of 10 of the largest third-party administrators.
Transparent Health Marketplace
Patricia Christiansen, Perspecta
Source: Perspecta, LLC