The Hospital Price Transparency is a regulation introduced by the Centers for Medicare and Medicaid Services (CMS) and took effect on January 1, 2021. This rule was implemented to force hospitals to be more transparent about the prices of services provided. Before this rule, finding a clear answer to what services may cost could be downright confusing.
With the Hospital Price Transparency Rule in place, patients can now compare prices much like one would do while shopping for other goods or services.
So how does one find the prices services at their local hospitals?
To comply with the Hospital Price Transparency Rule, hospitals must provide patients with standard charges and rates for all items and services. This information is normally found under billing on the hospital’s website. Patients could also try to search the key words such as “price transparency” on the hospital’s website. Another way to look at prices is to check out the price estimator on your hospital’s patient portal, such as MyChart.
The rule has also been expanded to require health insurance companies to share the rates they pay physicians and hospitals for services. Patients can check their insurance websites for prices. Information about what insurance will pay for and what the provider charges will allow users to see the most cost-effective route for them.
Like many new rules or laws, it may take time to transition into a useful working system. Many hospitals are still working on updating their systems and websites to be compliant with the new rule. If you have questions about billing and cost and are unsure how to navigate these new databases call your hospitals billing department and inquire about cost and where to access the information. You can also call your insurance company for rates.
Be proactive and informed: As a patient, you are your own best advocate. Take the initiative to research and compare prices across hospitals. However please keep in mind not all hospitals provide the same services, and many physicians may have contracts or limitations on what hospital they can provide services at. It is always a good idea to speak to your physician as well as looking into cost before making your final decision.
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