One of the great mysteries of medicine is how much tests, procedures and doctor’s visits cost. Unlike everything else, there is no price list or actual cost for these things. Each insurance company and plan has a different negotiated price. And the price varies depending on if the service is “in-network” or “out-of-network”. Ironically, patients who are paying with good old-fashioned cash are charged the most.
How can patients arm themselves with more information to negotiate a better rate?
Understand What Service You are Seeking
First you need to understand precisely what the service you are seeking is. For example, let’s say that you don’t have insurance and need a right heart catheterization. There are two components to your procedure: the physician part and the hospital part (even though the procedure is done as an outpatient and no overnight stay is needed).
Helpful Resources to Gauge the Reasonableness of Medical Costs
There are two websites that specialize in providing patients with cost information:
These websites have access to millions of healthcare claims and bills and use this information to provide reasonable ranges of costs. Once you are armed with this information you can approach your local hospital and begin negotiating with them for a cash price. Remember prices may vary wildly between hospitals. So do your homework and talk to a few different hospitals.
Talk to Your Doctor’s Office Before
When it comes to physician charges, talk to the practice manager and find out in advance what the rates are. There may be room to negotiate. In medicine, doctors benchmark their charges based on Medicare rates. Expect to pay slightly more than Medicare rates.
If you have insurance it still may be very important to understand in advance how much your procedure will cost. In-network charges may still vary dramatically between different in-network hospitals. If you are responsible for a deductible or co-insurance then this could mean thousands of dollars.
Stay tuned for more blogs about paying for healthcare.