🟢Ambetter (Centene)

This data contains the price transparency machine-readable files provided by Ambetter that have been normalized into easy-to-use tables.

Payerset Notes

Table of Contents

https://mrf.payerset.com/ambetter

Compliance Scorecard

Overall Rating: 4/5 - Good

Table of Contents

★★★★★

5/5

• Are the MRFs kept up to date each month?

• Is the Table of Contents link easily accessible?

• Is the Table of Contents properly formatted?

File Accessibility

★★★★★

5/5

• Are there any barriers to downloading the files?

• Do the Table of Contents links expire before publishing new links?

Data Quality

★★★★☆

4/5

• Is the data present in the files complete

• Are there significant gaps in any type of data

• Is the payer compliant with the regulations

Schema: AMBETTER

Data Validation

Record Type	Record Count
Negotiated Rates	7,039,078
Nonstandard Codes	0
Providers	140,257,643
Bundled Codes	0
Covered Services (Capitation)	0

Additional Observations

Machine-Readable Price Transparency Files Review

• MRFs Up-to-Date: ✔️ Yes, the MRFs are kept up to date each month.

• Table of Contents Accessibility: ✔️ The Table of Contents link is easily accessible.

• Table of Contents Formatting: ✔️ Yes, the Table of Contents is properly formatted.

• File Download Barriers: ✔️ No download barriers

• File Accessibility Percentage: ✔️ 100% of the files are accessible.

Overall Assessment: These files are posted by Centene and are generally pretty good, however we have received feedback that they are missing data for which there is definitely a contracted rate, specifically for Imaging and ED codes for a few hospitals in Arkansas. We are looking into this issue and will make Ambetter aware of any findings.