Health plans are increasingly providing patients with specific dollar estimates for physician office visits, according to an American Medical News report.
During the past year, several health plans have released new versions or made significant updates to their cost estimation tools. While the old tools showed only rough guesses as to the cost of physician visits, the new ones show a negotiated price as well as the anticipated cost to the patient depending on his or her benefit plan. The new tools also show how much of the deductible is met.
According to the report, the projection comes with a disclaimer that notes the insurer can't guarantee the accuracy of the estimate.
The AMA and other physician organizations have criticized the move to list cost information in isolation from meaningful quality indicators, saying patients will use cost as a proxy for quality if they don't have quality information. The latest cost estimation tools list some indication of relative clinical quality, though information is inconsistent; sometimes the clinical quality "data" simply lists a physician's board certifications.
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During the past year, several health plans have released new versions or made significant updates to their cost estimation tools. While the old tools showed only rough guesses as to the cost of physician visits, the new ones show a negotiated price as well as the anticipated cost to the patient depending on his or her benefit plan. The new tools also show how much of the deductible is met.
According to the report, the projection comes with a disclaimer that notes the insurer can't guarantee the accuracy of the estimate.
The AMA and other physician organizations have criticized the move to list cost information in isolation from meaningful quality indicators, saying patients will use cost as a proxy for quality if they don't have quality information. The latest cost estimation tools list some indication of relative clinical quality, though information is inconsistent; sometimes the clinical quality "data" simply lists a physician's board certifications.
Related Articles on Coding, Billing and Collections:
Aetna Program Aims to Increase In-Network Referrals
Illinois Rep Introduces Bill to Require Disclosure of ASC Charges
22 Statistics on Best Payors for Physicians by Specialty