At Common Ground Healthcare Cooperative (CGHC), we are committed to delivering trusted and understandable information to members. To this effect we are providing the following resources:
Transparency in Coverage
Transparency in Coverage Disclosure
The Transparency in Coverage Disclosure provides members important information to help them ensure their services will be covered as outlined in their insurance plan and to help them understand their costs. You can view the Transparency in Coverage Disclosure by clicking the button below.
Transparency of Pricing Data
In 2020, the federal government created new regulations that require health insurers and group health plans to provide cost-sharing data to consumers. This is called the “Transparency in Coverage” rule. These new requirements offer consumers tools to better understand their healthcare costs.
We are meeting the requirements of the Transparency in Coverage Rule and upholding our value of putting our members first by making health care costs available to consumers.
Machine-Readable Files (MRF)
These files provide pricing data for covered items and services. CGHC began posting machine-readable files publicly on the website starting on July 1, 2022, and we update these files monthly.
The Transparency in Coverage Rule requires three types of Machine-Readable Files:
IMPORTANT – Machine-Readable Files are the first step in making this information more available to consumers. However, these files are not consumer-friendly. They require specialized software to open and view the data and are designed for use by researchers, regulators, and application developers. CGHC doesn’t provide or support any software needed to view these files. To view the Machine-Readable Files, please use the MRF links above.
Price Transparency Tool
CGHC provides members with access to cost estimates for all covered services. Members can access this self-serve tool by logging into the My Health Portal. The Price Transparency Tool provides a cost estimate per billable code. To receive the most accurate price for a procedure, which may include multiple billable codes, we recommend you contact your provider’s office and/or the facility where the service(s) will be performed. They will know all the codes that might be billed for the encounter and can provide a more complete estimate for the service(s) you plan to receive.
Web Access to Member Healthcare Data
In 2020, the Interoperability and Patient Access Rule was created to make healthcare data more available to consumers. CGHC provides members with easy access to all healthcare data that we maintain for them via a web portal or a mobile app of the member’s choosing. Before enrolling in this service, CGHC recommends you learn more about Protecting your Data and Selecting an App.
To start the process of setting up an account to access and share your healthcare data, follow the instructions below:
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- Visit our HealthLX Portal
- Use the New User? Click Here to Register link
- Follow the on-screen instructions to enroll. You will need your member ID, last name, and date of birth (DOB)
- Each adult member on a policy will need to register themselves for the HealthLX Portal
- A parent/guardian can register minors on a policy
- Once registered, you can view your past claims that were covered by Common Ground Healthcare Cooperative. This is the data that you can share with third-party authorized health history apps of your choosing.
If you are a developer and would like more information on working with CGHC’s Interoperability APIs please visit our Developer Portal.
If you have any questions or need additional assistance, please contact us!