Transparency in Coverage, Simplified.
As regulations continue to evolve, Opala is committed to helping our customers stay ahead by turning compliance complexities into clarity.
That’s why we’re excited to introduce our Transparency in Coverage (TiC) Compliance Solution, a purpose-built product that helps payers and pharmacy benefit managers confidently meet CMS-9915-F requirements for Prescription Machine-Readable Files.
Built in close partnership with our customers, this new offering transforms a complex regulatory process into a streamlined, automated workflow so that you can focus on serving your members, not managing files.
Why It Matters
Meeting Transparency in Coverage mandates takes more than technical capability. It requires a deep understanding of regulatory guidance, operational realities, and data integrity.
With timelines tightening and penalties increasing, health plans need a scalable, proven path to compliance—without disrupting day-to-day operations.
Our solution delivers exactly that.
How It Works
Transparency in Coverage isn’t just another compliance tool—it’s a smarter way to stay compliant.
Here’s what sets it apart:
- Collaborative by design: We work directly with your team to interpret CMS guidance and ensure every requirement is met.
- Automation with assurance: Pricing data is securely transferred (via SFTP or your preferred method), rigorously validated, standardized into CMS-approved JSON format, and automatically published each month.
- Reliable and ready: Files are hosted on a secure, user-friendly platform, archived for audit, consistent month-to-month, and always easy to access.
No access barriers. No missed deadlines. Compliance that simply works.
Built for What’s Next
Regulatory change is constant—but so is our commitment to keeping you prepared.
Our Transparency in Coverage solution is designed to evolve as requirements shift, ensuring your compliance processes remain efficient, scalable, and future-ready.
At Opala, we believe data should flow freely, and compliance should be seamless.
This Transparency in Coverage product is one more way we’re helping healthcare organizations turn mandates into momentum.
