If you don’t believe that shopping around for your medical care can make a difference, you must read this story by Dr. Jeffrey Rice, the CEO of HealthCareBlueBook.com. Dr. Rice’s 12 year-old son Jack required a minor outpatient surgery:
Jack’s surgery was scheduled at the local hospital’s outpatient surgical facility. I called the hospital to request a price for the surgery and they said they couldn’t really tell me. They offered to send the procedure codes to an external reviewer who would provide a general idea of the anticipated charges. Three days later the answer came back at $37,000. I reiterated that I had high deductible insurance and needed to know the actual price they would bill me after an insurance adjustment to the network fee schedule.
The hospital next referred me to my insurance company. The insurance company referred me to their PPO network. The PPO network said that they could not reveal the prices until after the case was performed. I called back to the hospital.
At this point the hospital said that they could not tell me how much the discounted price would be either and they also wouldn’t negotiate a cash price with me. They expected the discounted price to be in the range of $15,000 to $25,000. They also offered to limit my out of pocket portion to $10,000. I am now on day six with over a dozen phone calls; not the price I expected for a 2 hour outpatient procedure.
In the end, Dr. Rice and his son’s surgeon were able to schedule Jack’s surgery for an ambulatory surgical center. Price tag for the procedure: $1,515.
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