Open & View MRFs (Machine Readable Files)

What Are Machine-Readable Files?

Machine-readable files (MRFs) are structured data files, often in JSON or CSV formats, designed for computer processing rather than human readability. They are a key component of the Transparency in Coverage (TiC) regulations, which mandate healthcare insurers to disclose negotiated rates with providers. These files aim to provide stakeholders like employers, providers, and analysts, with the raw data needed to analyze costs, compare prices, and make more informed decisions about healthcare services.

Here’s a very simple JSON snippet modeled after a payer Transparency in Coverage (TiC) machine-readable file. This is only for training and explanation. The real files are far larger and more complex (often billions of rows).

{
  "reporting_entity_name": "Example Health Insurance Co",
  "reporting_entity_type": "health_insurance_issuer",
  "plan_name": "Example PPO Plan",
  "in_network": [
    {
      "negotiation_arrangement": "ffs",
      "name": "Example Medical Group",
      "billing_code_type": "CPT",
      "billing_code": "45378",
      "billing_code_type_version": "2020",
      "description": "Diagnostic colonoscopy",
      "negotiated_rates": [
        {
          "negotiated_price": 875.00,
          "negotiated_type": "negotiated",
          "service_code": ["22"], 
          "provider_groups": [
            {
              "npi": ["1234567890"],
              "tin": { "type": "ein", "value": "12-3456789" }
            }
          ]
        }
      ]
    }
  ]
}

Common Uses for MRFs in Healthcare

1. Price Transparency: Organizations use MRFs to uncover negotiated rates for services and benchmark costs.
2. Data Analysis: They provide raw data for building cost models, identifying trends, or detecting anomalies.
3. Compliance: Insurance companies and hospitals use MRFs to ensure compliance with regulatory requirements for transparency.

Challenges with MRFs

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While MRFs offer valuable raw data, they present significant hurdles:

• File Size: MRFs often span multiple gigabytes and contain billions of rows, making them difficult to open with traditional business friendly tools like Excel.
• Complex Structure: Nested formats like JSON are not easily navigable without specialized tools. It's also not uncommon for these large files to be invalid or malformed.
• Irrelevant Zombie Rates: MRFs often include numerous reimbursement rates that are technically published but not actively used in real-world claims. These can include placeholder values, inflated outliers, or legacy rates that don’t reflect actual contracted payments. Without filtering these out you risk benchmarking against data that isn’t commercially relevant. Zombie rates and duplicates can account for as much as 90% of the data found in MRFs (which is why we use proprietary AI combined with external claims-based validation to cleanse MRFs). ‍
• Limited Context: A single MRF only provides one piece of the puzzle, often lacking the context needed for actionable insights for negotiations or comprehensive analytics across the market.

How to Open and View MRFs

Viewing MRFs With Free Tools

If you’re just getting started, there are a few free desktop tools that can help you open and inspect machine-readable files:

• Notepad++ and Sublime Text
  Both are free text editors that let you open JSON or CSV files. They will show you the raw structure, but even a small payer file can contain millions of lines of nested data. You’ll likley find it overwhelming to navigate, and the information will be very hard to interpret without flattening and filtering.
• Dadroit JSON Viewer
  Dadroit is a lightweight desktop tool that visualizes JSON hierarchies, which makes it easier to expand and collapse sections. This can help you understand the structure of the files without scrolling endlessly through raw text.

While these free tools are useful for initial exploration, they come with major limitations:

• File size: TiC files often exceed several gigabytes, and your local machine memory will often crash or freeze when trying to open them.
• Limited functionality: Even if the file loads, it's very likely you'll be staring at irrelevant data. Zombie rates and duplicates can account for up to 90 percent of the rows. Without filtering these out, you risk drawing the wrong conclusions.
• No built-in analytics: These tools only display the data. They don’t offer pivots, aggregations, or enrichment, which are essential for benchmarking and negotiations.

In other words, free tools can help you see the files, but they won’t help you use them for meaningful analysis.

View MRFs with Gigasheet

Gigasheet is a browser-based platform designed for working with large, complex datasets and has been purpose built for price transparency data. Gigasheet Price Transparency Solutions delivery fully cleansed, enriched, and pre-analyzed price transparency data. However, we also offer tools for self-service exploration. Follow these steps to open and explore MRFs:

1. Upload the File
   • If you haven't already, sign up for a free Gigasheet account. You can get started for free with CSVs, but JSON files require paid plan. You can learn more about our price transparency solutions here.
   • Upload your MRF file into your Library. Gigasheet supports large files and common formats like JSON and CSV. Gigasheet support files up to 250GB+.
2. Gigasheet Automatically Processes the Data
   • For nested JSON files, Gigasheet automatically flattens the structure into columns for easier navigation. Large files can take a while.
   • For our price transparency customers we provide access to preprocessed data for any payer or market. This data has been cleansed of zombie rates and enriched with NPI and Medicare GCPIs and expert 1-1 support and guidance.
3. Analyze the Data
   • Filter, sort, and pivot the data to find meaningful insights.
   • For example, filter rows by billing code to identify specific negotiated rates.
4. Export as Needed
   • Save subsets of data for further analysis or share with your team.

Why MRFs Alone Aren’t Enough

Although MRFs provide raw data on negotiated rates, relying solely on one file is unlikely to yield actionable insights for price benchmarking or negotiations. Here’s why:

1. Zombie Rates: many (and sometimes most) rates in MRFs aren’t actually used in practice. Without filtering out these inactive or inflated values, benchmarks can be misleading.
2. Limited Scope: MRFs typically only include data for a single insurer or payer. To benchmark effectively, you need data from multiple payers and providers.
3. Market-Specific Insights: Negotiations require a deeper understanding of market trends, focus areas, and competitive pricing.
4. Data Preparation: Cleaning, normalizing, and comparing data across MRFs is labor-intensive and requires advanced tools.

The Gigasheet Solution: Tailored Price Transparency Analytics

If you’re looking to streamline the complex process of analyzing MRFs and benchmarking prices across your market, Gigasheet for Price Transparency is your answer. Our tailored offering includes:

• Ability to cleanse and analyze any payer dataset to aggregate and compare pricing information.
• Prebuilt workflows to clean, normalize, enrich and benchmark data.
• Insights tailored to your market, clinical focus area, and provider network.

With Gigasheet, you can focus on strategy rather than data wrangling, giving you the edge in negotiations.