Can patients obtain price quotes on website?

Although 9,700 transactions were paid online by patients, totaling over $2 million in a nine-month period in 2011 and 2012 on San Diego-based Sharp HealthCare's website, those same patients can't yet obtain price quotes for services electronically.

"We have yet to refine a price estimator tool on the web," says Maria Jimenez, director of patient access. "I am not aware of any hospitals that currently offer this."

The biggest obstacle in offering online quotes is that the price is reflective of only the information provided by the patient or the patient's physician, Jimenez explains. "There is a possibility that the surgical procedure or planned service extends beyond the initial quoted price, due to unforeseen circumstances," she says.

Patients call hotline

Sharp Metropolitan Medical Campus has set up a "self-pay hotline" for patients to call and leave specific pieces of information so that a patient access representative can provide a verbal and written estimate.

"Most patients that access this hotline do not have insurance to cover their immediate healthcare need," Jimenez says. Patients are asked to leave as much information as possible on their healthcare needs, including the physician's name and phone number and the procedure's CPT code if available.

An access service representative then contacts the provider office to validate information given by the patient and generates a written estimate. "We have found that having a physician contact assists with providing patients with the most accurate cost estimate," says Jimenez. The patient's medical history and existing co-morbidities is valuable information to have, particularly for a self-pay quote for an inpatient procedure, she adds.

"It's important to know if a patient has pre-existing medical conditions," says Jimenez. "Our self-pay pricing methodology is based on Medicare DRG as a baseline. A DRG with complications and comorbidities, versus one without, may vary significantly in costs."

Sources

For more information on giving price quotes to patients, contact:

• Kathy L. Hughes, FHFMA, Director, Patient Accounts and Admitting, St. Anthony's Medical Center, St. Louis, MO. Phone: (314) 543-6946. Fax: (314) 525-1649. Email: kathy.hughes@samcstl.org.

• Maria Jimenez, Director, Patient Access, Sharp HealthCare, San Diego. Phone: (858) 939-3708. Fax: (858) 939-3141. Email: Maria.Jimenez@sharp.com.