Some revenue cycle leaders are not waiting to find out what new requirements for price transparency will come from regulatory bodies or governments. Instead, they are moving full speed ahead on their own.
“Online posted prices are complex and confusing” for patients, says Kathy Delis, administrative director of revenue cycle support services at the University of Utah Health in Salt Lake City.
The hospital created something much better for patients. The “See Your Out-of-Pocket Costs” tool combines chargemaster prices with an individual’s insurance information.
“This tool provides a simple way for patients to understand the cost for their care,” Delis explains. More than 40,000 patient estimates have been generated in the year and a half since the tool was developed. As word spread, use has doubled. As with all hospitals, the chargemaster prices are posted for all to see. However, when patients view those, they will find a link to the new tool. “This gives more meaningful information,” Delis offers.
The patient selects a service and enters his or her type of insurance (commercial or government) and whether he or she has a copay, coinsurance, or deductible. The tool factors all the information, along with six months of similar cases and what they cost, to produce a highly accurate price estimate. The tool does not compute costs for complex services with a high degree of clinical variability. This is handled by the patient financial advocate team.
“We work through the complexities in service or payer coverage to ensure most accurate estimate possible,” Delis says.