Increased participation in high deductible health plans (HDHPs) and Health Savings Accounts (HSAs) puts increased pressure on the consumer’s wallet and in turn, more patient responsibility to understand what they are paying for their health care services. The problem – health care pricing has always been a mystery.
It only makes sense that educated consumers should be able to compare prices for health care services, as you would any other product or service before buying. Unfortunately price transparency in health care is rare, and many doctors are unable to keep up with what their recommendations will cost the patient. There is a movement happening however, that aims to uncover the mystery of health care pricing and empower patients to make informed health care decisions.
It is no secret that price disparities in health care services exist and prices may vary depending on where you receive treatment. However, you may be shocked to find out just how large these discrepancies can be. According to a recent WSJ article, “a hospital in Pennington, N.J., charged $3,036 for a diagnostic and screening ultrasound, while one in Bronx, N.Y., billed just $88.” While price alone should not be the sole determinant of where you receive care, an informed health care consumer could potentially save thousands if they are willing to put in a little work on the front end.
Here’s how you do it:
While complete price transparency for health care is something we hope to achieve in the future, there are resources available today that can provide some guidance for comparing prices for treatments, tests, and medications. One example is www.healthcarebluebook.com. Designed similar to, you guessed it – Kelly Bluebook for auto listings, Healthcare Bluebook was started to provide health care consumers with a place to go to determine a “Fair Price” for health care services in their area. Being armed with information that allows you to make smarter health care choices could potentially make a huge difference for your long term financial picture.
Healthcare Bluebook’s website will show you how to work with your doctor to find a Fair Price and how to shop around to find an in-network provider who will honor, or at least come close to the fair price.
1. Determine the Fair Price and discuss with your doctor
- Know the specific service you need. Ask your doctor for the name and billing code of the health care service in question. The more specific you can be, the more accurate pricing you can receive.
- Determine the Fair Price for your service on www.healthcarebluebook.com and document it. If you can’t find it on their website, you can submit a request to see if they can find a Fair Price for you.
- Call your doctor’s office before you have the procedure done to discuss their pricing for the service you need. Ask to speak with the person in the office who can discuss pricing. Be sure to share your insurance details as well, and ask if there are any additional fees associated with the particular service or procedure.
2. Shop around and get it in writing
- If your doctor’s pricing is not comparable to the Fair Price in your area, contact other in-network providers (your insurance company can help you determine who these are) to see what their pricing is for the procedure or service. Discuss insurance details and pricing with each in-network provider in order to find the best price in your area. Before engaging a new physician or specialist, be sure to research their qualifications, experience, and reputation as costs should not be the only determinant when choosing a provider.
- Once you decide on a provider and have an agreed upon price, always get it in writing – have the office staff send you an email or write down the agreed upon price for you. Pay attention to the bills you receive following the service to ensure that you are not paying more than the agreed upon price. If there is a discrepancy, contact your doctor’s office and have them correct the bill for you.
Many of us have been blissfully ignorant health care consumers. If it is recommended by our doctor, then it must be the only option…right? Not necessarily – talk with your doctor about your treatment options. Understand what he or she is recommending and why, and negotiate a fair price before proceeding with any procedure. As the responsibility for health care costs continues to shift onto the consumer’s shoulders, take the opportunity to be more engaged in your health care so that you can make smarter decisions for your health and your finances going forward.
Consumers with a HDHP/HSA combination are more price-sensitive to health care services than consumers with a traditional health care plan. If you have recently switched to a HDHP/HSA arrangement or are thinking about making the switch, click here to read our February newsletter to learn more about how to make the most of your health savings account.