Asked about costs? Give first-rate service
While many patient access departments can give patients the estimated full cost of a service, to date, very few are able to provide an accurate out-of-pocket estimate, says Becky Peters, regional director of patient access services for Sutter Health West Bay in San Francisco.
“Challenges include understanding what specific services the patient is asking about,” says Peters. “There are so many new procedures and different variations for given procedures.” For surgical cases, the specific surgeon and the type of equipment used could affect the total cost of the procedure.
To help patients understand their out-of-pocket responsibility, four hospitals in the Sutter Health network launched the Patient Care Price Estimation Service. The service is available for patients covered by private insurance, self-pay, government-sponsored programs, or any combination of these payment methods.
“Patients deserve to know their out-of-pocket costs. It helps them make an educated decision about where and when to receive care,” says Peters. “No one likes surprises, especially when they are also dealing with an illness.” These steps occur:
1. Patients call the financial counseling office, just as they did before.
However, the previous tool could only give the patient the estimated total cost. “Our new tool is much more robust, accurate, and quicker,” says Peters. “We can pull the individual patient’s insurance information and give them the estimated out-of pocket costs.”
2. Registrars give a price estimate in a manner of minutes while on the telephone with the patient.
“It is done ‘real time.’ Prior to having this enhanced service, it could take several hours of research and multiple calls with patient,” says Peters.
3. Staff proactively reach out to patients with scheduled elective procedures to discuss out-of-pocket costs.
“It gives us the opportunity to assess if the patient will have any financial difficulties in covering their costs,” she says. “If that is the case, we work with them right away to discuss financial options.”
4. Patients and family members are encouraged to ask about the cost of care and make their own choices about what will work best for them.
Registrars automatically provide estimates to scheduled patients, and physician offices and clinical departments inform patients about the service.
“To us, it is all about consumer choice, whether it is about the cost estimate or how quickly they obtained it,” says Peters. “Our goal is to make the decision as easy as possible.” (See related story on what to tell patients, below.)
Sources
For more information about price estimates, contact:
• Karen Hughes, CHAM, Manager, Insurance Verification, Riverside Regional Medical Center, Newport News, VA. Phone: (757) 243-2141
Fax: (757) 223-5165. Email: [email protected]
• Becky Peters, Regional Director of Patient Access Services, Sutter Health West Bay, San Francisco. Phone: (415) 505-4988. Email: [email protected].
• Robin Woodward, CHAM, Patient Access Director, Riverside Regional Medical Center, Newport News, VA. Phone: (757) 594-4211. Fax: (757) 594-4495. Email: [email protected].
While many patient access departments can give patients the estimated full cost of a service, to date, very few are able to provide an accurate out-of-pocket estimate, says Becky Peters, regional director of patient access services for Sutter Health West Bay in San Francisco.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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