TALON
Torchbearers of Transparency in Healthcare

The enactment of the Transparency in Coverage Rule and No Surprises Act was a turning point in the battle against skyrocketing healthcare costs in the U.S. It requires group health plans and health insurance providers to disclose price and cost-sharing information to all participants. This data, provided in a consumer-friendly format, will enable consumers to evaluate their healthcare options and make cost-conscious decisions.

TALON finds its existence deep-rooted in this purpose.

Its powerful cost-containment tools facilitate affordable medical care for consumers while ensuring employers comply with federal laws.

Employees have long been in the dark about their healthcare costs, only seeing actual numbers when receiving bills weeks or months later. Going forward, organizations that fail to provide an internet-based self-service tool disclosing actual negotiated rate information and outof-pocket cost estimates for employees could face substantial fines of $100 per effected plan member per day, retroactive to the original date of non-compliance. Strengthened fiduciary rules could also lead to class-action litigation for plan sponsor breach or administrator breach as co-fiduciaries.

“Our advanced healthcare price transparency platform allows employers to achieve full compliance with all the regulatory requirements under the Transparency in Coverage Rule and No Surprises Act while reducing wasteful spending returning money to employees’ pockets and their employer’s bottom line,” says Mark Galvin, president and CEO of TALON.

As a staunch advocate for price transparency and consumerism in healthcare, Galvin, a serial entrepreneur, was driven to rectify the lack of transparency in healthcare coverage. Legacy pricing transparency solutions lack architectures built for the consumer and fail to meet compliance mandates.

When establishing TALON in 2014, Galvin developed MyMedicalShopper, a one-of- a-kind ML-based tool that empowers consumers to comparison shop and make informed and economical healthcare decisions.

The breakthrough for TALON came in 2018, when its expert leaders were invited to demonstrate the platform to the federal government’s health policy team. Impressed by the role that MyMedicalShopper could play in changing the healthcare system for better, the team used it as a reference to write federal mandates under the Transparency in Coverage Rule.

This makes TALON the only tool in the market that started with the architecture to comply with the mandates while others scramble to catch up. Three quintessential factors—price, quality, and convenience— make it a go-to platform for consumers who seek medical care and employers who want to be compliant.

Our advanced healthcare price transparency platform allows employers to achieve full compliance with all the regulatory requirements under the Transparency in Coverage Rule and No Surprises Act

The sophisticated yet easy-to-use mobile application is built on a massive cloud-based system that processes complex data from multiple sources. Its ML algorithms and statistical analysis validates collected data using a series of quality checks to ensure accuracy. By accessing, cleaning, and organizing data, MyMedicalShopper provides users with payer-specific negotiated healthcare price information, including out-of-pocket costs, prescription drug costs and in and out of network guidance. TALON has helped many employer groups gain significant savings with its solution. A case in point is a client with more than 225 employees enrolled in their selffunded health plan across 25 regional locations, with deductibles of $3,000. Using MyMedicalShopper, each employee saved an average of 22-percent of their annual medical spend as they could compare the price data beforehand and shop wisely. The employer witnessed a sustainable reduction in health insurance premiums and now achieved compliance.

TALON’s other proprietary tools include MyMedicalRewards, a patented shared-savings rewards program that incentivizes members for selecting lower-cost and higher-quality care options, ClaimsHindsight, a claims data engine, and MyPlanGuide, which helps users choose the right plan for their families at open enrollment. All these tools can seamlessly integrate with clients’ existing architectures and lower healthcare spending.

Equipped with exceptional solutions, TALON will continue to do what it does best—making healthcare more affordable and consumer-driven for Americans, all while maintaining full compliance with regulatory guidelines.