HOW CONSUMERS SHOULD USE PRICE TRANSPARENCY IN HEALTHCARE

FOR CONSUMERS WITHOUT HEALTH INSURANCE

Step One

Conversation with your doctor or other healthcare provider

Price transparency in healthcare provides an opportunity for consumers to know the cost before receiving care. You may decide to visit a hospital’s website or use available tools where you will be able to search and compare medical services costs. But if you have a primary care physician or a family doctor, we recommend asking your doctor the following questions:

  • What is the exact name of the service, treatment, or procedure?
  • What is the CPT code for the service, treatment, or procedure?
  • What ICD-9 or ICD-10 codes will be used?
  • Will other doctors be involved in my care?
  • What tests will I need before a surgery?
  • Will other doctors be involved in the surgery or procedure?
  • What medications and follow-up care will I need?

Step Two

Shopping for healthcare services

  • Request a price estimate or price inquiry: as an individual without insurance plan is extremely important to request a price estimate with specific information such as 1) what is included in the estimate; 2) which items are not included in the estimate; and 3) the total price of your care.
  • Compare healthcare prices: with publicly health care prices released by different providers, you should compare costs between different hospitals and shop around for the services you need.
  • Payment and financial opportunities: you may apply for financial assistance provided directly by the healthcare provider. Many individuals without insurance are eligible to receive a discount or an extension such as a payment plan.

For more information:

Price Transparency Solutions from Stairs

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