Additional Use Case: Price Transparency

COMPANY PLEDGE: We pledge to the CMS Interoperability Framework and to work collaboratively to accelerate implementation of Good Faith Estimates using standardized formats, leveraging existing claims infrastructure, Transparency in Coverage (TiC) and hospital price transparency data, and X12 and HL7 FHIR standards. By using these existing data sources together with provider and payer information, we will help deliver patient-specific estimates of expected out-of-pocket costs through patient-facing applications (PFAs) and networks. These estimates will reflect each patient's individual health plan benefits, cost-sharing responsibilities, and current plan status, providing more meaningful and accurate information before services are delivered. We believe patients should have access to timely, personalized cost information that supports informed conversations with their providers and better healthcare decision-making.