Summary
Learning the prices charged for different procedures, tests or use of medical premises requires work. There is no single source that has the information. To make matters more confusing, there is no single price in the health care industry. A doctor may charge one price to uninsured patients, another to patients covered by Medicare, and yet additional prices depending on what insurance company or plan covers the patient.
One alternative to learn about prices is to contact a service such as CoPatient . CoPatient will analyze your bill and send you a report including how much it believes you should have been charged. You can then either negotiate yourself or hire CoPatient to negotiate for you. If CoPatient negotiates for you, it charges a percentage of the amount of money it saves you.
Alternativle, consider the following steps:
- Step 1: Learn the name of the health care you need.
- Step 2: Look online to find what you can about the different prices charged in your geographical area.
- Step 3: Call the providers that have the quality you need which look to be the least expensive. Confirm what they charge.
- Step 4: Negotiate to find out if you can get a lower price.
NOTE: It is advisable to check the quality of a health care provider before agreeing to work with that provider. Information about how to do that is included in:
Step 1. Learn the name of the health care you need.
Step 2. Look online for costs in your geographical area.
- Independent web sites. For example:
- ChangeHealthCare.com (information is based on claims data from health insurers)
- HealthcareBlueBook.com
- NewChoiceHealth.com (information is based on information from Medicare data)
- OutOfPocket.com (is a search engine to help you find prices listed on different websites)
- PriceDoc.com
- Sites created by health care providers such as doctors or hospitals.
- Medicare Sites. For example:
- American Medical Association: www.ama-assn.org . Click on "Browse bookstore", then "CPT Online" then "CPT Code/Value Search".
- Medicare: www.cms.hhs.gov. Click on Medicare, then Physician Fee Schedule Look-up.
- State sites
- In your favorite search engine, type in words such as: compare health costs (name of your state)
- Insurance company web sites. For example:
- Aetna.com
- Anthem.com
- Cigna.com
- Humana.com
- United Health Care: uhc.com
- Check to see what approach the site takes to pricing. For example, some sites provide the list price -- the price the provider would like to get - but seldom does. Others list the price the Medicare pays. Sites from health insurance companies may list the price they pay.
- Check to find out what is and is not included. It may not be the same. For instance, for surgery, the price may not include the cost of the anesthesiologist (the person who monitors your vital signs and administers anesthesia).
Step 3. Call the providers.
- If you have an idea of price, confirm their charge.
- If you don't have an idea about their price, ask what they charge for a person in your situation (uninsured, insured, Medicare etc).
Step 4. Negotiate
If you have insurance, speak with your insurer to see if you can reduce your share of the cost. A particularly strong argument is if you lower the price the insurer will be charged. For example, if the insurer would normally be charged $5,000 and you are able to get the procedure for $4,500, you can ask that the company split the savings with you. More Information Related Articles
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