Several years ago, patient access leaders at Aurora, CO-based UCHealth kept hearing the same complaint. Patients were calling to ask about the cost of their care, but staff were unprepared to offer answers.
“That was a source of frustration not only in my department, but also ambulatory departments and clinics,” says Candice Hoshi, vice president of revenue cycle.
At that time, there was not a good price estimate tool available. Staff worked off a list of the most common charges, which was not much help to anyone. Price-shopping patients were not interested in gross charges that did not take their individual insurance into account. “What people wanted to know is how is it going to hit their pocketbook,” Hoshi says.
The department began a year-long project to fully implement a better price estimate tool. At the same time, a group of staff were designated to solely work on price estimates. “A lot of work went into training the patient estimate team,” says Matthew Kelly, senior director for patient access.
These highly skilled staff members can give good estimates to any patient who asks for one, whether at the hospital, for a scheduled procedure, or the ambulatory clinic. The hospital’s website also includes an estimate tool for price-shopping patients. In the last available six-month period, 4,189 estimates were completed.
To receive an accurate quote, patients must select the correct service, location, provider, and verify the insurance that is on file. If patients need any kind of help with estimates, they can call the patient estimate line. “We also added the ability for price-shoppers who are non-UCHealth patients to access the tool,” Hoshi says.
The estimates include both hospital and professional charges. It factors in outstanding deductibles, copays and coinsurance, and contracted prices with health plans.
To promote it to the public, the marketing team created a video introducing the price estimate tool and posted it on the UCHealth website. Patient access leaders alerted providers that there was a group of designated experts ready to provide price estimates. This is great news for providers, but also for patient access staff. “We were able to take that burden off their shoulders,” Hoshi adds.