Our local hospital hides the info pretty damn well. From the site main page, you have to go to the patient portal, then the billing department, and then a "pricing-transparency" page. That page is simply a landing page that lists SIX DIFFERENT unformatted spreadsheet files (.CSV). Each one is huge (hundreds of rows, dozens of columns) and impossible to browse from a cell phone or smaller tablet. You then have to cross-reference the CPT code (Current Procedural Terminology) of the service you received with one or more of these spreadsheets to find out what their current rates are for your situation. Where do you find the CPT code? On an itemized bill, which you have to request as they only send you a total bill at first. The best part is, depending on your insurance or lack thereof, you could end up paying one of several widely different prices. The CPT codes themselves are also impenetrable. Many of them don't actually explain what services they cover and are just placeholders for generic services. Go ahead and google CPT 99281 through 99285 and make sense of what that could be. Each one of those could have a widely different price.
Interestingly, my hospitals 'self-pay rates' (no insurance) are significantly lower than their insured rates. In my case, this meant that I actually paid more for an emergency room visit out of pocket than I would have without any insurance at all. Their self-pay rate was $780 for one CPT code but $2,550 when covered by my insurer. The hospital made an agreement with my insurer to bill for much higher rates for some CPT codes when they were involved. Since most people have a deductible and an even larger out-of-pocket maximum the insurer doesn't have to pay that full price in most cases. My insurer only reimbursed them for about $300 on that CPT code. I ended up owing the hospital over $2,200 because I had to pay the rest. I would have paid $780 without any insurance at all. Can you request the self-pay rates for situations where your deductible is high or something like that? Sure, but only BEFORE you receive treatment. After you have been treated they won't work with you on prices, only repayment plans. The best part? My hospital claims they are a non-profit.
My hospital system actually has the prices fairly accessible. Once you locate the page (search price list on their site), there are links to one JSON file per hospital.
Interestingly, you can see what the negotiated price for the various insurers is in addition to self pay. Current prices as of the end of December.
Our local hospital hides the info pretty damn well. From the site main page, you have to go to the patient portal, then the billing department, and then a "pricing-transparency" page. That page is simply a landing page that lists SIX DIFFERENT unformatted spreadsheet files (.CSV). Each one is huge (hundreds of rows, dozens of columns) and impossible to browse from a cell phone or smaller tablet. You then have to cross-reference the CPT code (Current Procedural Terminology) of the service you received with one or more of these spreadsheets to find out what their current rates are for your situation. Where do you find the CPT code? On an itemized bill, which you have to request as they only send you a total bill at first.
That's reasonable.
Sending everyone an itemized Bill is excessive, providing it on demand is reasonable.
Your complaint that their exhaustive list of codes snd fees is too long is, honestly, funny. You'd prefer what, fewer services? The charges were defined to work with insurance company computers, not casual visitors questioning their charges.
Your complaint that they "hide" patient costs in the patient portal off the main page is laughable.
Considering that as many as 80 percent of hospital bills contain errors they very much should be sending itemized bills to everyone. Also, those 6 different spreadsheets? They all have the same billing codes in them, just different prices. Do they explain anywhere why the code on one sheet is bill at one rate and a different rate on another? Nope, you have to call the billing department and ask. Besides, who is going to check over these codes on the ride to the hospital so they can be sure they don't get re
We cannot command nature except by obeying her.
-- Sir Francis Bacon
Available, but as hard as possible to access (Score:5, Interesting)
Interestingly, my hospitals 'self-pay rates' (no insurance) are significantly lower than their insured rates. In my case, this meant that I actually paid more for an emergency room visit out of pocket than I would have without any insurance at all. Their self-pay rate was $780 for one CPT code but $2,550 when covered by my insurer. The hospital made an agreement with my insurer to bill for much higher rates for some CPT codes when they were involved. Since most people have a deductible and an even larger out-of-pocket maximum the insurer doesn't have to pay that full price in most cases. My insurer only reimbursed them for about $300 on that CPT code. I ended up owing the hospital over $2,200 because I had to pay the rest. I would have paid $780 without any insurance at all. Can you request the self-pay rates for situations where your deductible is high or something like that? Sure, but only BEFORE you receive treatment. After you have been treated they won't work with you on prices, only repayment plans. The best part? My hospital claims they are a non-profit.
Re: (Score:2)
My hospital system actually has the prices fairly accessible. Once you locate the page (search price list on their site), there are links to one JSON file per hospital.
Interestingly, you can see what the negotiated price for the various insurers is in addition to self pay. Current prices as of the end of December.
Re: Available, but as hard as possible to access (Score:1)
Our local hospital hides the info pretty damn well. From the site main page, you have to go to the patient portal, then the billing department, and then a "pricing-transparency" page. That page is simply a landing page that lists SIX DIFFERENT unformatted spreadsheet files (.CSV). Each one is huge (hundreds of rows, dozens of columns) and impossible to browse from a cell phone or smaller tablet. You then have to cross-reference the CPT code (Current Procedural Terminology) of the service you received with one or more of these spreadsheets to find out what their current rates are for your situation. Where do you find the CPT code? On an itemized bill, which you have to request as they only send you a total bill at first.
That's reasonable.
Sending everyone an itemized Bill is excessive, providing it on demand is reasonable.
Your complaint that their exhaustive list of codes snd fees is too long is, honestly, funny. You'd prefer what, fewer services? The charges were defined to work with insurance company computers, not casual visitors questioning their charges.
Your complaint that they "hide" patient costs in the patient portal off the main page is laughable.
Re: (Score:2)