Achieving True Pricing Transparency for Patients

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Publishing true prices of procedures gives you a strategic advantage over your competition. Patients appreciate knowing exactly how much their out-of-pocket costs are going to be. With deductibles growing higher and the burden of payment on consumers, being one of the first in your market to publish prices sets you apart and gives you more control.

HFMA offers transparency guidance

The Healthcare Financial Management Association (HFMA) has published a bulletin, “Recommendations for Improving Price Transparency,” that offers excellent guidance on publishing pricing for consumers. Tip No. 5 says: “Suppliers of price information should make sure that price estimates are accompanied by explanations of what services are included in such estimates, as well as the impact of differences in network status on such estimates, to help patients make valid comparisons among providers. For example, when comparing prices associated with receiving an imaging service, the patient should be informed if the estimate includes the facility costs associated with taking the image and the radiologist’s fee for the professional reading.”[1]

There are products on the market that use historical data such as claims or previous billing records to provide estimates for procedures. But these are just estimates and usually don’t include out-of-pocket calculations for the patient. Or, you may have solutions that provide ranges for prices, such as MRI of the leg ranging from $1,000 to $2,000. With such large ranges, the patient is left wondering exactly how much his specific MRI is going to cost.

We can do better than estimates

HealthQRS’ point-of-service solution uses the actual payer contracts by provider plus insurance verification information plus charity plus other business rules to calculate the true out-of-pocket per patient per procedure:

True Patient Responsibility

 Our solution goes far beyond estimates because we provide true pricing. We help your scheduling and registrar team explain the whole picture to your patient. We provide interactive scripts on the scheduling or intake screen to help staff members collect the full deductible upfront or discuss setting up payment plans with patients. This is helpful for team members who aren’t used to discussing financials with patients. Our scripts give your team confidence to help your patient and your practice. In turn, you collect more of your money rather than pennies on the dollar months after the procedure is complete. Not only does your bottom-line improve, we’ve found that prepayment creates less no-shows.

Ready to learn more about HealthQRS’ Retail Medical Marketplace? Click here to schedule a demo, or feel free to contact us with any questions.

[1] “Recommendations for Improving Price Transparency,” HFMA, Mar 10, 2015,

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