Healthcare cost transparency; this new website can help you negotiate medical fees.
One of the biggest problems for consumers is the cost of care, especially as more of us find out that our insurance plan has a high deductible. These so called consumer based plans are supposed to expose patients to the cost realities that their insurers face, however, most consumers are putting off needed care until either their deductible has been met or when the problem becomes much more severe.
While patients need to have skin in the game, they are now expected to call, shop and try to figure out who is a better value for a given procedure or office visit. In an emergency such as shortness of breath or chest pains, patients are most likely to go to an emergency room, rather than visit their doctors office or wait. They are also not going to call around as to who is cheaper, especially since there is no price transparency. Most patients believe that their insurer will fairly negotiate their hospital or doctors fees, however, sometimes they are surprised as to how much the allowance is for a doctors visit, which may only last 15 minutes.
A new website that is patterned after the Kelly blue book, a guide people have used to figure out the value of a car they are thinking of buying is trying to do the same with healthcare costs.
If you need an MRI of the spine, it gives you a number, a physician visit, another number and it even gives you an agreement you can fill out and hand to a healthcare practitioner after you negotiated the fee in advance. This is unlike my wife’s recent experience looking for a specific type of doctor who takes no insurance, tells her that the first visit is $450 (with no reason or basis for this high evaluation cost) and a second follow-up being $425 and then regular visits costing $275. If you go on the web site for a more complex evaluation which this is not, a level 4 evaluation allowance is $349 which is quite generous, about $100 dollars cheaper.
Without having any basis for negotiation, the consumer is left to their own devices, and now, with most of the plans being sold through the exchanges being EPO (no coverage outside of the network), when you visit an out of network provider (insurers networks may not have everything you want or need), you need to know if you paying a fair market fee or just being gouged. Unfortunately, when you have a healthcare problem that has not been solved using doctors in your network (not that uncommon), it may just be that a 10 minute in network visit is not enough, and perhaps an out of network doctor possesses a skill or area of expertise that your insurer does not provide.
Using https://www.healthcarebluebook.com may help you solve the problem or perhaps, help you successfully negotiate the fee of a doctor you were recommended to that you want to visit. Unfortunately, there is no rhyme or reason to most medical pricing and quite honestly, it is like they took numbers out of thin air in many cases. Using Healthcare Blue Book can give you the confidence to negotiate fees on your own.
Healthcare Blue Book will not force a doctor to negotiate with you, and it is not giving you bargain basement pricing. On the other hand, it gives you a price that allows you to begin negotiating with, a method to negotiate with, a written agreement you can print out and some sense of price transparency.
The next time you need to visit an out of network doctor, be sure to use Health Care Blue Book first before you call. Depending on how much the doctors office wants your business, your willingness to negotiate with them up front will save you money and help you become part of the market solution for healthcare costs.
Unfortunately, insurers have helped keep costs high for all of us, even with their negotiated fees. I personally believe that part of the problem is the willingness to pay for tests and procedures, rather than the time a doctor needs to fully evaluate and understand your problem which leads to costly consultations and referrals and such. The insurers, by squeezing portal of entry providers such as your family doctor, has helped make healthcare more expensive since your primary doctor cannot afford to spend the time, and therefore, a referral is easier and more cost effective for them, not for you or for the system to be more efficient.