Billing and Collections
A recent American Journal of Managed Care study has confirmed prices for care in a hospital outpatient department tend to be higher than those for the same service performed in a physician's office.
Two states are making inroads into revealing some of the biggest secrets of health care by publishing price information to help consumers comparison shop for doctors, dentists and prescription drugs.
Price estimates for routine medical procedures are difficult, often prohibitively so, to come by for consumers in major metropolitan areas, despite price transparency provisions in the Affordable Care Act and in many individual states. That's the word from two expert researchers from the Pioneer Institute and Northeastern University.
St. Clair Hospital in Pittsburgh and Experian Health, the healthcare-focused business branch of Experian, announced a new online cost transparency tool Monday called Patient Estimates that will make it easier for patients to get a clear picture of what their out-of-pocket financial obligations will be for services at the Hospital or it's outpatient centers.
If a physicians' group, hospital or revenue cycle management company can prove that its paper-based billing method is faster and less expensive than a paperless alternative, Tom Furr has a $10,000 check with their name on it. That's the premise behind the "$10,000 Healthcare Billing Challenge" being held by PatientPay, of which Furr is CEO.
In a recent study, Truven Health Analytics found more than a $10,000 price variation in bundled spending for knee and hip replacement, depending on geography.
A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices. That's the word from the Centers for Medicare and Medicaid Services, after issuing its final rule Tuesday establishing a prior authorization process for certain durable medical equipment, prosthetics, orthotics and supplies.
Two professional organizations representing emergency doctors warn that a new federal rule could lead to higher out-of-pocket costs for consumers when they need emergency care outside their health plan's network of providers. But consumer advocates and health policy experts say the groups' proposed solution doesn't adequately protect consumers.
The prices hospitals negotiate with private insurers vary considerably across geographies, according to a new study by the Health Care Pricing Project, driving huge variations in health care spending for the privately insured.
A new survey of hospital and health system senior executives by by Kaufman Hall found that while 96 percent of healthcare organizations say understanding patient needs is important, only 13 percent really understands what those needs are.