Comments on: More Transparency For Network Negotiated Prices http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/ Research and discussion of the Colorado health insurance industry and the healthcare crisis in America. Wed, 17 Mar 2010 21:46:03 +0000 http://wordpress.org/?v=abc hourly 1 By: Heather Ellis http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/comment-page-1/#comment-12946 Heather Ellis Tue, 09 Dec 2008 19:18:40 +0000 http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/#comment-12946 For two years now, I've been trying to help my son decipher medical estimates (Vail Medical Center and Steadman Hawkins) and insurance responses (BCBS), for surgeries and aftercare he has needed since someone rear-ended his vehicle. (Don't you love the move back to the "tort" system?) I completely agree with the sentiment that it's so very hard to acquire, let alone argue with determinations. I have the patience and knowledge, and I'm the advocate. But what about a patient in pain, or someone young, elderly, or otherwise ignorant of the system? Regarding rates, though: I have found it very interesting how many providers are willing to offer discounts to patients who don't have the full amount covered. One therapist's office actually had a sign stating that they offered a 40% discount for uninsured. I think it speaks to both the exorbitant charges for procedures and the amount of time even providers have to spend to get money out of the insurance companies. For two years now, I’ve been trying to help my son decipher medical estimates (Vail Medical Center and Steadman Hawkins) and insurance responses (BCBS), for surgeries and aftercare he has needed since someone rear-ended his vehicle. (Don’t you love the move back to the “tort” system?) I completely agree with the sentiment that it’s so very hard to acquire, let alone argue with determinations. I have the patience and knowledge, and I’m the advocate. But what about a patient in pain, or someone young, elderly, or otherwise ignorant of the system? Regarding rates, though: I have found it very interesting how many providers are willing to offer discounts to patients who don’t have the full amount covered. One therapist’s office actually had a sign stating that they offered a 40% discount for uninsured. I think it speaks to both the exorbitant charges for procedures and the amount of time even providers have to spend to get money out of the insurance companies.

]]> By: Jay Norris http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/comment-page-1/#comment-11228 Jay Norris Tue, 29 Jul 2008 04:55:06 +0000 http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/#comment-11228 Susan, I was thinking of starting up an engine like that last year, but noticed there were already other sites starting that same thing. The best one I know of so far is www.carol.com, but it still doesn't have that big of a database yet. Susan,
I was thinking of starting up an engine like that last year, but noticed there were already other sites starting that same thing. The best one I know of so far is http://www.carol.com, but it still doesn’t have that big of a database yet.

]]> By: Susan Viet http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/comment-page-1/#comment-11209 Susan Viet Sun, 27 Jul 2008 15:39:49 +0000 http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/#comment-11209 I had the same thought/experience last year pertaining to a $6300 PET scan. The CO Surgeon General's office said that neither party was required to share the negotiated rate. They noted that they get "several calls a day" asking about this. Maybe we should start a site where people can list the quoted cost, the actual cost, the place of service, and the insuarnce compamy? That way we could choose where we have the procedure done and which insurance company might be best for our specific needs? I had the same thought/experience last year pertaining to a $6300 PET scan. The CO Surgeon General’s office said that neither party was required to share the negotiated rate. They noted that they get “several calls a day” asking about this. Maybe we should start a site where people can list the quoted cost, the actual cost, the place of service, and the insuarnce compamy? That way we could choose where we have the procedure done and which insurance company might be best for our specific needs?

]]> By: Mr. Shiney http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/comment-page-1/#comment-9202 Mr. Shiney Fri, 29 Feb 2008 20:44:27 +0000 http://www.healthinsurancecolorado.net/blog1/2008/02/28/more-transparency-for-network-negotiated-prices/#comment-9202 A related issue has to do with transparency of network discounts between two different in-network hospitals. There is sometimes a huge difference -- Hospital A may only give a 5% discount and Hospital B may give a 40% discount. So for the same procedure, even though both hospitals are "in network", the patient could pay much more at Hospital A, than Hospital B. If there is a major difference in quality of care, outcomes, etc. that's one thing. But otherwise the patient is missing out on some important information. Insurance companies should disclose to their covered patients if a particular network provider has a discount that is significantly less than the average discount. A related issue has to do with transparency of network discounts between two different in-network hospitals. There is sometimes a huge difference — Hospital A may only give a 5% discount and Hospital B may give a 40% discount. So for the same procedure, even though both hospitals are “in network”, the patient could pay much more at Hospital A, than Hospital B. If there is a major difference in quality of care, outcomes, etc. that’s one thing. But otherwise the patient is missing out on some important information.

Insurance companies should disclose to their covered patients if a particular network provider has a discount that is significantly less than the average discount.

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