New rules requiring hospitals and other healthcare services to post procedure charges began this week but not everyone is a fan.
Tammi Imm is the Vice President of Front End Revenue Cycle at Rochester Regional Health, which means she collects patient payments and oversees charging for the hospital.
She believes the posting of charges online may end up confusing patients more than helping them. She says the charges that are posted online are what the hospital charges, before insurance and other aid is factored in.
She uses the analogy of buying a car to describe this method.
"There’s an MSP on a car, the invoice price, let says its $20,000. But we know nobody will pay $20,000. You can go to a dealership and based on rebates, dealership discounts and other negotiations, a consumer would pay $15,000. That’s the differential."
So she doesn’t want patients seeing a number online and maybe not seeking out services, based on that price.
Imm says she’d rather patients contact their estimates hotline for a more refined calculation of pricing. Although this number still wouldn’t be the final price, she says it’s at least closer to what a patient will be charged.
"So what our team would do is look at similar cases where a patient had had that in the past, or other patients had that in the past. So we have a good idea of what the cost of those services or like services would be. And then they would adjust down based on that particular patients plan."
She says pricing is also open because other procedures could be added.
"There’s going to be reasons why medical care may vary. It may be based on medical necessity. There may be complications with a case. There may be additional costs based on what the provider determines is necessary for that particular patient, so things can happen that can cause the final bill to differ from that initial "good faith" estimate that we're trying to provide."
The RRH estimates hotline is 922-COST (2678).
She says they see around 600 calls a month to this hotline, and expect it to increase with the new online posting requirement.
Imm also says patients should contact their insurance providers to make sure a procedure is covered. She believes CMS is doing the right thing advocating for pricing transparency, but think that may lead to more confusion in the end.