Give a spot-on quote: It requires research
A prospective patient at St. Anthony's Medical Center in St. Louis, MO, can request a price quote be worked up by filling out a simple form on the hospital's website.
"But no one is using it," reports Kathy L. Hughes, FHFMA, director of patient accounts and admitting. "Instead, they just pick up the phone."
If a patient completed the online form, he or she would be called back by a financial counselor, who would then work up a price quote, but patients choose to call directly instead.
"The website also gives them the phone numbers to call, should they just want to speak with someone about the cost of a procedure," says Hughes. "We don't offer the ability to look up the price online."
The reason? There are so many variables involved, such as knowing the exact kind of test being performed, what kind of insurance the patient has, whether the patient has met their deductible for the year, and the contract price in place with the insurance company, she explains. "The reason that we do not just offer a look-up service that the patient can access is the potential for them to see a charge and be turned off," says Hughes. "We would offer it if we felt that patients had enough knowledge to use it correctly. The technology exists."
Patients might not understand that what they will owe is impacted by their insurance plan and their benefit structure, for example. "The insurance benefits and contracts and types of plans are so complicated that sometimes the experts don't even understand it," says Hughes. "We sometimes have to call the doctor's office to get more information."
Specifics matter
To provide a price quote, the financial counselor needs the exact name of the test that the doctor has ordered or, preferably, the CPT-4 code, says Hughes.
There would be a difference in the price quote, for example, if the patients said they were having a CT scan with contrast and it turned out to be a CT scan with and without contrast, or if the patient said they had Medicare, but it turned out to be a Medicare HMO plan.
"Patients get frustrated when we ask for all of this information, because they don't understand all that goes into it," says Hughes. "We explain that we want to give them a good estimate."
A prospective patient at St. Anthony's Medical Center in St. Louis, MO, can request a price quote be worked up by filling out a simple form on the hospital's website.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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