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Dec 02

Price Transparency: How it Benefits Providers

Patient demand for healthcare price transparency is on the rise. It may surprise some, but this can be a good thing for providers.

As the prevalence of high-deductible health plans increases, patients are shouldering more of the cost burden for healthcare. This has led to an increase in consumers “shopping” around for their healthcare needs. In fact, more than half of Americans have looked for healthcare pricing information before getting care.1

However, it can be challenging for patients to find resources that detail the cost of service and confusing to translate the pricing information once it’s found. There are many online estimators available, but they may give vague ranges of possible costs, limit the number of procedures they price, or use outdated pricing data.

There’s also increasing governmental pressure to publically disclose healthcare pricing. According to the Health Care Incentives Improvement Institute, “Many states have introduced or enacted legislation for public reporting of pricing across providers and, in some cases, specific to certain payers operating in that state.”

How Does Price Transparency Benefit My Practice?

  1. With so many patients looking for pricing information, providers who are able to serve up accurate information in an easy-to-understand format could get ahead of their competitors. Patients have become more savvy consumers. Put yourself in their shoes. Would you rather buy from an organization that lets you know upfront how much a service will cost, or one that makes you guess?
  2. Providing upfront pricing estimates sets patients’ expectations of their payment responsibility, which can help support collections at your office. Reminding patients of the payment due prior to their appointment will improve the chances that they arrive prepared to pay. It will also promote a better relationship with patients by reducing the feelings of frustration that come from receiving a bill that’s higher than expected.

Where Should I Start?

  • Review the Health Care Incentives Improvement Institute’s annual Report Card on State Transparency Laws, which provides an overview of state laws and upcoming actions related to healthcare pricing transparency.
  • Contact MicroMD to learn more about tools to increase your likelihood of getting paid, including Patient Responsibility Estimation. This tool estimates a patient’s financial responsibility as early as when they schedule their appointment, so you can set payment expectations. Use one online portal to find pricing information from more than 200 payers. The estimates are based on the latest pricing information, your previous 30 days’ worth of remit data or an uploaded provider fee schedule.
To ensure you get paid what you’re owed, read the attached whitepaper from TriZetto Provider Solutions to learn three tips for rapid patient payment.

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