Case study details how direct claims administration platform integration eliminated a 13-step manual compliance workflow and activated real-time member cost transparency from a single data pipeline.
Portsmouth, NH – July 15, 2026 – TALON, the healthcare price transparency infrastructure company, today released a case study showing how a regional nonprofit health plan reduced its Transparency in Coverage (TiC) machine-readable file (MRF) cycle time from 45 days to less than one day. By integrating directly with the plan’s claims administration platform, TALON eliminated a 13-bundle manual processing workflow while enabling a real-time member cost transparency experience using the same trusted pricing data.
The health plan had previously relied on a non-specialized vendor solution that required manual data extraction and transformation from its claims administration platform, sustained coordination across four or more internal FTEs and two to three external contractors, and continuous cloud infrastructure management. The cycle was expensive to run, difficult to audit, and exposed the plan to evolving CMS schema requirements without a clear remediation path.
The case study illustrates how health plans can reduce administrative costs while creating a reusable pricing data foundation for member engagement and future transparency initiatives.
Key Outcomes
- MRF cycle time reduced from 45 days to less than one day
- 13 manual processing bundles consolidated into a single automated pipeline
- Four-plus internal FTEs redeployed from MRF operations to higher-value work
- 2.4x return on the technology investment through automation and infrastructure elimination
- Reserved cloud compute environment retired
- Real-time member cost transparency experience launched using the same pricing dataset that powers MRF generation
The unified architecture integrates directly with the health plan’s claims administration platform as the system of record for pricing data. TALON’s processing layer applies compliance logic, validation, and CMS schema formatting, then produces two aligned outputs from a single source: regulatory-compliant MRFs and a member-facing treatment cost calculator. The design eliminates the reconciliation layer that typically causes data divergence between compliance files and member shopping tools.
“The complexity is just gone. We don’t have to manage this process anymore, and we have much greater confidence that our pricing data is accurate and compliant.”
The Health Plan’s Software Development Lead
“Machine-readable files shouldn’t be treated as just another compliance checkbox. When health plans build a trusted pricing data foundation, they can power compliance, member shopping, claims repricing, and network analytics from the same infrastructure.”
Mark Galvin – Founder and CEO, TALON
TALON supports more than 80 health plans and TPAs, integrates with more than 16 claims administration platforms, maintains 99.9% U.S. commercial MRF coverage, and provides pricing data for more than 2.8 billion procedures.
Read the full case study to learn how the health plan modernized its MRF production process while creating a single pricing data foundation for compliance and member transparency.
About TALON
TALON is the healthcare price transparency infrastructure company enabling health plans, TPAs, and benefits advisors to convert regulatory compliance into a competitive advantage. TALON’s platform powers MRF production, claims repricing, member shopping, and network analytics for organizations serving employers, unions, and public sector plans nationwide. Learn more at talonhealthtech.com.
Media Contact
Matthew McCormick, VP, Growth Strategy, TALON
Matthew.McCormick@TALONhealthtech.com | 603-303-2098
