Humana API MarketplacePlan and Issuer Price Transparency
The plan and issuer Transparency in Coverage final rule requires plans and issuers to publish their negotiated payment rates for in-network providers and their allowed amounts for out-of-network claims. We’ve created these machine-readable files to assist in meeting this requirement.
In-Network
In-Network files by plan name – For each Commercial Plan, a file is generated of the providers and the negotiated rates between the provider and Humana to pay claims
Out-of-Network
Out-of-Network files by plan name – For each Commercial Plan, a file is generated of the providers and the allowed amounts for that Out-of-Network provider
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