Regional Health Plan Going Beyond the No Surprises Act for Price Transparency


In response to the No Surprises Act, a regional health plan aimed to offer its members more than the required basic cost-sharing information. They sought to develop a comprehensive price transparency tool that would include all possible charges associated with medical procedures, providing members with accurate and meaningful cost estimates.


  • Partnered with SourcEdge to analyze millions of claims and build a sophisticated Price Transparency Solution (PTS) that offers detailed cost breakdowns, including deductible and copay information.
  • Developed a user-friendly online portal where members can search for treatments by name, code, or keywords, view facility prices, physician affiliations, and access external quality resources.
  • Received positive feedback from members, with thousands of searches conducted monthly, enhancing member satisfaction and engagement.
  • The versatility of the new Cognizant technology-based platform ensured the sustainability of custom features during a platform migration, securing the investment and future-proofing the tool.
  • Gained recognition as a national leader in price transparency, receiving numerous awards for their forward-thinking approach and commitment to member-centric service.