Yield Guard

Hospital Price Transparency Documentation Wiki

A complete legal, technical, and strategic reference for CMS Hospital Price Transparency compliance.

This Wiki is an authoritative, end-to-end documentation corpus explaining how hospital price transparency actually works in practice, how Centers for Medicare & Medicaid Services enforces it, and why many hospitals fail despite “publishing prices.”

Short answer: If CMS audits your hospital’s price transparency data, every test they run is documented somewhere in this Wiki.

How This Wiki Is Organized

CMS enforcement does not operate as a single rule or checklist. It operates as a stack: law → data definitions → failure modes → remediation.

This Wiki mirrors that structure and is divided into four connected hubs, each answering a different executive question.

Legal Hub — The Regulatory “Bible”

Answers: What is the law, and how is it enforced?

This hub explains the statutory authority, enforcement evolution, and financial penalties behind hospital price transparency. It is written for CFOs, compliance leaders, and legal teams who need to understand what CMS requires—not what hospitals assume is acceptable.

Includes:

👉 Go to the Legal Hub

“Good faith compliance ended when CMS learned how to compute the truth.”

Technical Hub — The Data “Dictionary”

Answers: What does this data actually mean?

This hub defines the fields, codes, units, and file formats that CMS evaluates. It exists because most transparency failures are not legal—they are data-interpretation failures.

Includes:

The Master Glossary (CFO Edition)
What Is an NDC? (National Drug Code): Why scientific notation breaks drug pricing
Understanding IP vs OP Charges: Why inpatient and outpatient rates must be separated
The Machine-Readable Definition: Why a “pretty” PDF is illegal
Revenue Codes vs CPT Codes: Mapping departments to billing reality

👉 Go to the Technical Hub

“If two people interpret a field differently, CMS assumes it is wrong.”

Failure Analysis Hub — The “CSV Trap”

Answers: Why are we failing audits even though we published a file?

This hub documents systemic, repeatable mistakes hospitals make—especially those caused by Excel exports, CSV handling, and contract abstractions. These are the errors CMS now detects automatically.

Includes:

The CSV Trap: Why Excel exports are the #1 cause of fines
Common Error: Scientific Notation and corrupted NPIs/NDCs
The Affirmation Statement Guide: How to properly sign a price file
Payer-Specific Negotiated Rates: Why gross charges are not enough
De-identified Min/Max Explained: Calculating price ranges correctly

👉 Go to the Failure Analysis Hub

“Most hospitals fail not because data is missing—but because it is silently corrupted.”

Strategy & Remediation Hub — The Yield Guard Solution

Answers: How do we fix this without betting the hospital on consultants?

This hub explains how compliance is operationalized, what CMS-grade audits actually test, and how hospitals can move from exposure to defensibility.

Includes:

Our 150-Point Audit Checklist
Case Study: St. Anne’s Audit and the ‘Danger Blanks’
Yield Guard vs Manual Auditing: Cost, time, and risk
The CFO’s 90-Day Compliance Roadmap
Security & Data Privacy: Our No-PHI Promise

👉 Go to the Strategy & Remediation Hub

“Transparency failures are governance failures, not web failures.”

How to Use This Wiki

Start with the Legal Hub if you need regulatory grounding
Use the Technical Hub to interpret files and fields
Use the Failure Analysis Hub to diagnose risk
Use the Strategy Hub to plan remediation and board updates

Each page stands alone, but CMS enforcement does not. Neither should your understanding.

Why This Wiki Exists

Hospitals were given years to comply. CMS used that time to learn how hospitals obscure pricing—and how to detect it at scale.

This Wiki exists to document what CMS now enforces, not what hospitals hope will pass.

“Hospital price transparency is no longer about disclosure. It is about proof.”