Patients covered through a CIGNA healthcare plan could be less confused about their payments following the spring launch of CIGNA's Cost of Care Estimator.
The Estimator's real-time cost estimates detail portions of the bill to be paid by CIGNA's health plan and the covered individuals' sources of liability - whether that comes from out-of-pocket costs due to co-insurance or co-pays or flexible spending accounts, health reimbursement arrangements or health savings accounts.
"As healthcare cost-sharing becomes increasingly prevalent, it is vitally important to educate individuals about how their health plans work and improve their understanding of the actual costs of medical services and how those services will be paid," said Joan Guttman, system director of patient access at Resurrection Health Care, a Chicago-based non-profit healthcare system.
By providing itemized cost estimates and explaining the sources of paymen based on the individual's specific plan, the Estimator is designed to help people understand their benefits and how much they owe for specific services, officials said. It will also serve as the basis of pre-care financial discussions in order to help avoid after-the-fact financial surprises.
"We've tested Estimator with patients and found that it can help reduce confusion and the potential for late payment of medical bills and bad debt issues," said Guttman.
The tool facilitates an up-front financial discussion that allows for payment arrangements, anticipating account contributions to pay for services in the future and discussions around treatment options, according to Cigna officials. It's designed to be available for all medical services, including high-cost procedures.
Healthcare professionals can quickly obtain estimates using existing desktop technology, Cigna officials said, so medical practices and hospitals need not invest in new technologies to use the Estimator tool.
"Every other service industry provides estimates of cost prior to service - for the first time we are systematically trying to do this for healthcare," said Jeffrey Kang, MD, CIGNA's chief medical officer. "From the customer perspective we are helping them make informed choices prior to service and avoiding potential 'sticker shock.' From the physician's perspective, we are reducing the risk of bad debt because the individual is informed prior to service. Overall, this will improve the doctor-patient relationship and allow them to focus on the more important goal of health improvement."