Hospitals to provide more price estimates
Although the process is slow, local hospital systems are working to give potential patients more pricing information up front.
The health company has launched an online form that consumers can use to obtain estimates within three days for services at its
The online price estimator can be reached at: www.promedica.org/Pages/patient-resources/billing-insurance.
The form is designed to help those get an idea of what final out-of-pocket costs will be with various insurance plans, said
"Our rep will contact the insurance company, look at the benefits, calculate out what it would be, and then give the patient an estimate from there so that they know what they would pay out-of-pocket,"
The telephone line, 1-844-220-0800, has been in operation for several years and receives about 100 calls per week,
The web tool is available anytime, and
That version is expected to launch early next year.
To receive an estimate, consumers must enter their names, the type of procedure they plan to have, and the name of their insurance carrier and account number.
Information provided on the form states the estimate represents hospital services only and does not include related fees, such as those for a surgeon, radiologist, pathologist, or anesthesiologist, and that the estimate is subject to change and is not a final bill.
"And that's the challenging part about health-care services. You come in and you don't necessarily know what you're going to run into, so it could be more complicated than what was initially thought or you could have complications from a procedure, so it is definitely an estimate,"
Price estimators are one of the best tools available to help health companies become more transparent about their pricing, said
UTMC is also slowly rolling out its own online price estimator called E Care Next, he said.
Members of the public cannot access the website form on their own, however, said
"It pulls the most up-to-date information on the patient's insurance plan to provide a specific estimate of the patient's responsibility.
Working with E Care Next there are 135 insurance plans in the system which covers most of our patients,"
Officials at Mercy indicated they do not now have a way to give patients upfront estimates.
But
"We anticipate this team will 'go live' in the fall of 2015 and will share more at that time of what exactly will be part of the center, what patients can expect, and what services will be available," she said.
These steps being taken by
American consumers are accustomed to comparison shopping for most goods and services, but hospital and physicians' fees were not much of a concern when health insurance companies paid the bulk of those bills, said
As consumers are being asked to cover more of their health-care costs through rising premiums, deductibles, and co-pays, they are becoming more price-conscious, said
"As people are increasingly taking on a more significant share of their payment, pricing is moving more into a retail environment,"
That move has angered other health organizations because its ads contain a chart comparing the clinic's retail price for some common tests and procedures with those of area hospitals. Local hospital executives allege the ads are often inaccurate.
Although
What a consumer pays out-of-pocket for a particular procedure varies significantly depending on insurance status and the type of plan.
"The struggle is, how do you create meaningful transparency for the consumer?" he said.
Some national websites with free pricing web tools seem to have landed on at least one path to greater transparency.
Both healthcarebluebook.com and newchoicehealth.com allow consumers to get estimates on prices for procedures in their area.
Both sites provide estimates in the form of price ranges or, in the case of Healthcare Bluebook, what is called a fair price for the local area.
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