Local hospitals launch online cost estimate tools for medical care

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Hospitals across the country have a new tool you can use to help you know how much your medical care will cost before you open a bill with an unexpected steep price tag.

The U.S. Departments of Health and Human Services, Labor, and Treasury released the Transparency in Coverage Rule in 2020. In part, it gives patients the ability to see how much their health care could cost with their insurance coverage before they go in for treatment.

The ultimate goal of this rule is to add transparency to medical costs and help drive down health care costs in the long run by increasing competition.

Cone Health released its online tool before the start of the new year. It’s available either on the health system website or through the MyChart App patients can use for their medical care.

With the tool, patients can select a number of different services which range from scans like different kinds of X-Rays and M.R.I.s to mental health services, maternity and more.

“They can create an estimate based on the information they put in the estimator. The caveat with that is the estimate is only as good as the information you put in,” Cone Health Vice President of Revenue Cycle Mike Simms said.

Simms said it’s important to remember the number is only an estimate, and it’s difficult to calculate the costs. There can also be external costs for services that might come from outside of the health care system. He says the tool is a good way for patients to be more informed about their health care.

“I do think it is a benefit to a certain extent for patients because our industry is very complicated. It’s not like going into Jiffy Lube and getting a price for an oil change. There are so many complications involved and services that we provide, surgeries, combination of CTs and various other procedures. So, it’s not an exact science,” Simms said.

The healthcare systems are not the ones in charge of dictating the out of pocket cost for patients.

“There’s one thing you have to understand. We don’t determine the benefits that our patients have with their insurance provider, so whatever their deductible is or their co-insurance, they’ve made that decision,” Simms explained.

He says patients also have to consider more than only the bottom line when making decisions on their health care.

“The key point in this is quality. I want to go where there’s quality in my physicians. And price is a factor, but if I go down that list, I’m going to look at what my physician says, the quality, and then I’m going to look at price,” he says.

Once patients have a better understanding for the projected cost of medical services, they can start planning.

“That also allows the patient to plan for payments. Again, unexpected hospitalization or services that are needed, the patient may not have the funds available. So we have various methods for the patient to pay, and giving them that information in advance allows them to budget that,” he said.

An example of medical costs most families could have to plan for is maternity costs. 

“When an expectant mother goes to the O.B. and gets the wonderful news they’re going to have a baby, at that point in time they can plan out seven months in time. They can get the estimate and then seven months in advance they can make their payments and be paid up by the time of the delivery,” he explained.

One of the most important impacts of this tool is reducing the sticker shock people might face when they don’t know ahead of time what the costs could look like for services.

“That’s the biggest thing that we want to try to avoid is patients having surprise billing, not knowing what it’s going to cost. And then they get this bill in the mail for 2000 dollars, and it’s oh I wasn’t really expecting that and I didn’t really plan for that. So this will really help with that,” Simms said.

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