Transparency in Downcoding Act prohibits discriminatory downcoding by health insurers.

The Transparency in Downcoding Act aims to prevent health insurance issuers from downcoding claims based solely on diagnosis codes or in a discriminatory manner. It mandates that downcoding decisions be made by a physician with relevant expertise and experience. Insurers must notify physicians of downcoded claims and provide detailed information, including the reason for downcoding, revised service codes, and the physician's credentials. The act also establishes an appeal process for physicians to contest downcoding decisions.

Transparency in Downcoding Act prohibits discriminatory downcoding by health insurers.

The Transparency in Downcoding Act aims to prevent health insurance issuers from downcoding claims based solely on diagnosis codes or in a discriminatory manner. It mandates that downcoding decisions be made by a physician with relevant expertise and experience. Insurers must notify physicians of downcoded claims and provide detailed information, including the reason for downcoding, revised service codes, and the physician's credentials. The act also establishes an appeal process for physicians to contest downcoding decisions.