Access to files and compliance
Blue Shield supports greater transparency around the cost of health care and is working in good faith to comply with the requirements of the machine-readable files (MRF) provision of the transparency in coverage final rule (TCFR).
Our contracted provider network pricing information will be publicly available when ready, through the MRF files linked below, and will be updated monthly.
View Blue Shield of California MRF files
View Blue Shield of California Life and Health Insurance Company MRF files
It is important to note that even when final data files are available, the information will be difficult to use to make direct comparisons among plans. Final reimbursements are based on many factors, including quality, patient outcomes, or innovation investments.
To learn more about the TCRF and MRF provisions, refer to the Centers for Medicare & Medicaid services fact sheet.
These files are extensive collections of data to be ingested and read by machines, and are not intended for member use. The TCFR also includes provision for a member Cost Estimator Tool to be made available by January 1, 2023, which we are also working towards.
Our current treatment cost estimator can be accessed when logged in at blueshieldca.com, under “My plan”.
Contact your appropriate Blue Shield service center with any questions:
Member services: 1-800-393-6130
Producer services: 1-800-559-5905
Provider services: 1-800-541-6652
• For groups 1-100: (800) 325-5166
• For groups 101-3,000: (855) 747-5809
• For groups 3,001+: (888) 686-5751