This content was originally published by the Longmont Observer and is licensed under a Creative Commons license.
Patients are always concerned about the cost of medical services. What many do not know is that hospitals across the U.S. are required to post their prices for services online.
Both Longmont United Hospital and UCHealth Longs Peak Hospital comply with these requirements. But just looking at these lists of services and numbers can be confusing and not always accurate.
To combat patient confusion each hospital has created an online tool to assist patients in determining the cost of services based on their unique situation. These tools account for your insurance, how much remains of your deductible and if you qualify for other discounts.
Longmont United Hospital
Longmont United Hospital wants to provide patients with an estimate that is specific to each person. "While we do believe that the intention of the new requirements of the new law was to allow patients to have a better grasp on how their medical costs are broken down before insurance, the reality is that the charges that an individual is going to receive is complex and unique to each person," states Director of Media Relations and Public Relations, Centura Health, Wendy Forbes.
In order to accomplish that goal, Longmont United has created online tools to help patients determine their out-of-pocket costs on an individual basis. Customers are also encouraged to contact the hospital to request a custom estimate.
"We realize that that is not always possible to do in an emergency situation, you aren't going to have time to sit there and research but anybody who has a planned procedure, we would recommend doing this because it gives them the ability to make better choices themselves and to ensure that they are going to a facility or a caregiver that's in their insurance network. A lot of people get a surprising bill when they go out of network in particular because their insurance benefits don't kick into the full capabilities that they may have," states Forbes.
Forbes also wants patients to understand that while the estimation tools can provide an estimate that closely reflects payment, some other factors may come into play when the bill arrives. She provides the following example:
"If a person becomes inpatient, things can happen, you don't know if a complication, for example, would arise. Let's say they come in to have a surgery and know what the cost of the surgery would be but then some sort of complication is encountered, it's one of those challenges that at any time, patients have the right to ask questions, number one, and family members do as well. That is something we also want to ensure that people are advocating for is to make sure that they have a very open dialogue with their caregivers but to understand that nothing can be perfect because it is one of those situations that is always evolving."
UCHealth
UCHealth also includes medical charge and self-pay information online for patients to review. However, according to Senior Director, PR and Communications, Dan Weaver, "Those prices do not include the discounts which patients with insurance receive and they don't include the discounts that uninsured or self-pay patients receive either. So those prices that are posted online make it very difficult or perhaps impossible for a patient to understand what their actual out-of-pocket responsibility might be for a service."
"UCHealth is focused on providing an excellent experience for our patients and this includes providing accurate and useful estimates for our services," says Weaver.
UCHealth has also designed an online tool to estimate patient out-of-pocket costs. Their website includes a short video on how to use the estimation tool.
"That tool factors in the discounts that we provide, factors in the patient's own insurance situation and even how much of a deductible or out of pocket maximum a patient has currently met during their plan year," says Weaver.
And that is why the UCHealth price estimate tool can accurately provide out-of-pocket estimates for patients, which is what we think is what patients are really looking for when they are contacting us and asking us about prices and asking us for an estimate.
Health care is not a one-size fits all system. There are many factors to juggle when determining the cost of medical procedures. Patients are encouraged to do two things to be smarter consumers: know their insurance benefits and to request a custom estimate for all planned procedures.
"That is really important for the consumer to do to ensure that they are getting the maximum value of their insurance product," says Forbes.
