chunkyfrog wrote:Wouldn't it be nice if we had access to some kind of guide to costs, by city, state, or even provider?
I can't help thinking that price transparency would be a huge factor in lowering the cost of healthcare.
I wish! The private insurance companies and the doctors don't want that or wont allow it -- at least not now.
It took me weeks, yes weeks, to compare costs for my sleep study. It was virtually impossible, and in the end, almost pointless. I called local hospitals, the sleep lab my MD referred me to, and the sleep labs listed by Blue Cross. Each one was a nightmare to get estimated costs from. They all needed the diagnosis code, and procedure codes, etc., in order to give me a guess. The sleep labs gave a rough guess, but only with the codes could they be more accurate. At the end of the day, it wasn't the billed cost, but what BCBS would agree to pay that was important.
In the end I just said to heck with this and went with the preferred provider that did full home testing. The sleep lab people billed Blue Cross $6,000. The BCBS preferred provider 'discount' was -$5,021, and so the contracted amount allowed was $979. BCBS then paid out $783.20 to the lab and my portion I owed was 195.80.
Welcome to American healthcare! (Pre-ACA....). Where we pay more for care than any other civilized country, and have worse medical outcomes....
I used to have United Healthcare and they had a rudimentary online cost comparison tool for some procedures like knee replacement, gallbladder surgery, colonoscopy, etc. However nothing like sleep studies, etc. was included. And it was still very rudimentary. Nothing like Dr. Jones charges X for a bypass and Dr. Smith down the street charges $100 less. Because, frankly, with the private healthcare insurance industry, it makes little difference what Dr. Jones 'charges' unless you pay cash (Gd help you!) -- it's what the special contracted rate the
insurer will pay Dr. Jones for that procedure that matters to the patient in the end. If you have a 20% co-insurance you have to pay, then it would be helpful to know what your
insurer pays, and what your share will thus end up being for using the 'preferred provider'.
But trying to get those minute financial details out of the insurer is virtually near impossible. It is all part of the secret contracts they have with the individual doctors and hospitals. The insurers will not usually ever divulge the amount. You, as a patient, only learn the dollar amount when the bill comes!