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by xdmr
1381 days ago
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For comparison, here's the first bit of an Anthem file (which contains some of the data that's just another row in the Humana record), along with the first record "reporting_entity_name": "Excellus BlueCross BlueShield",
"reporting_entity_type": "Health Insurance Issuer",
"last_updated_on": "2022-06-14",
"version": "1.0.0",
"provider_references": [
{
"provider_group_id": 302.1518360704,
"location": "https://mrf.healthsparq.com/exc-egress.nophi.kyruushsq.com/prd/mrf/EXC_I/EXC/providerReference/Providers/S-000000001063.json"
}
],
"in_network": [
{
"negotiation_arrangement": "ffs",
"name": "Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a benefi",
"billing_code_type": "HCPCS",
"billing_code_type_version": "2022",
"billing_code": "G0081",
"description": "Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a benefi",
"negotiated_rates": [
{
"negotiated_prices": [
{
"negotiated_type": "fee schedule",
"negotiated_rate": 51.1,
"expiration_date": "9999-12-31",
"service_code": [
"11"
],
"billing_class": "professional"
}
],
"provider_references": [
302.1518360704
]
}
]
},
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Negotiation arrangement: for fuck’s sake