New Law Requires Hospitals to List Procedure Costs Online - NBC 5 Dallas-Fort Worth

New Law Requires Hospitals to List Procedure Costs Online

Prices posted online could vary by insurance provider

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    NEWSLETTERS

    New Law Requires Hospitals to List Procedure Costs Online

    Hospitals will soon be required by law to post procedure costs online. Experts warn the numbers may not always add up. (Published Friday, Dec. 28, 2018)

    You will soon be able to go online and see what hospitals are charging for medical procedures.

    Starting Jan. 1, hospitals are legally required to post procedure costs online.

    “This is a great first step in the right direction, but in Texas, we talk about the two step. Right, there is step two, and three, and other steps have to come down the road,” said Seth Denson, the chief strategist for GDP Advisors, a health care consulting company.

    Denson warns this new change could become confusing. While the prices are there, they could vary depending on your insurance.

    "I now have to understand what the network discount is each insurer has with the hospital to correlate it down to my actual cost," said Denson.

    We reached out to some of our local hospital systems about the new law. A spokesperson from Baylor White sent us a statement, saying:

    "We believe that pricing transparency needs to be meaningful for patients seeking information about actual out-of-pocket costs, and our organization has made significant investments over the past five years to implement technology and processes to help patients get the information they need to make decisions about their care.

    On the “Estimate Your Cost of Care” page on BSWHealth.com, an automated price estimation tool is a reliable source for specific estimates of out-of-pocket costs because it combines our pricing (charges), contract terms and rates, and real-time eligibility and benefit information to produce a unique estimate for each patient. It is on this webpage that we are posting the list of standard charges mandated by the Centers for Medicare & Medicaid Services (CMS).

    Our pre-registration team makes proactive phone calls for patients with a scheduled service to provide them with an estimate in advance of service, and our price estimate team provides price shoppers with the opportunity to call, email or chat with us online to obtain an estimate for potential services at one of our locations."

    A spokesperson for Cook Children said:

    "Cook Children’s is dedicated to publicly providing standard charges for treatment so patients and parents can make the best medical decisions for their family. However, sharing meaningful information is challenging because pediatric care is specifically tailored to the needs of each child. As always, we are committed to making care more affordable by efficiently using our resources, providing preventive care in the communities we serve and helping patients qualify for financial assistance when needed. Cook Children’s standard charges will be posted on our website on Jan. 1."

    A spokesman for Texas Health Resources said:

    We support the new CMS requirements regarding increased price transparency. Texas Health hospitals have been sharing their inpatient pricing since original ACA requirements went into effect. Beginning on Jan. 1, we will begin posting our procedure pricing in machine-readable format on our website as well. Patients should be aware that the exact cost of their care will be dependent on many factors, including their specific set of procedures, their insurance coverage, and the amount of their deductible that has already been met prior to the new procedure. The exact cost can also be affected by any changes or additions to the procedure that are ordered by the patient’s physician or surgeon. Patients can get a cost estimate for a procedure at any facility in the Texas Health family of hospitals by going online here or calling 1-877-PRE-ADMT (1-877-773-2368).

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