The next time you have an injury or illness that requires immediate care, consider using an urgent care center rather than the traditional hospital Emergency Room.  Urgent care centers are staffed by physicians, offer sort wait times, are less crowded, cost a fraction of what hospital ER visit would cost you, and you can walk in without an appointment.  The urgent-care centers are equipped to handle anything from a simple cut and treating broken bones, to deploying advanced life-support equipment.  Some offer discounts and payment plans and many health insurance plans cover urgent-care clinics.

The CDC published interesting statistics on the unnecessary and overuse of hospital Emergency Rooms. In 2005, 115.3 million people visited Emergency Rooms and only 5.5% of the patients needed to be seen immediately. Only 21% of theses ER visits were identified as semi-urgent and needing to be seen within one to two hours, and 14% of these visits were evaluated as non-urgent

Source: Laura Landro, "Options Expand For Avoiding Crowded ERs," Wall Street Journal, August 6, 2008.

SmartMoney just published an article, Top 5 Times to Haggle for a Better Deal.  The article incudes useful tips on how you can get a better deal the next time you purchase health care services. 

Pay cash upfront.  Providers sometimes will offer you the same lower rate that they negotiate with insurance companies, or possibly even a cheaper rate if the consumer agrees to pay cash at the time of service.  I tried this and it worked!  Just be sure to ask up front.   

Compare Costs.  Check your providers rates against other doctors in your area.  You can look this information up through tools provided by your insurer, or by using the community search tool, OutofPocket.com to view patient posts of actual prices paid for services.  Providers have been know to lower their fees to stay competitive so be sure to do your homework and research prices before you visit the provider.

Last month the Wall Street Journal forum, Doctors Charges, had an interesting discussion on consumers experience comparison shopping for health care services.  Everyone seemed to agree that is is practically impossible to find out beforehand what patients are expected to pay.    Read what other consumers had to say about their experiences shopping for health care services. 

AOL recently posted tips to help you save money on health care costs.  Consumers should not have to pay full price for services.  One of the tips recommended that consumers should use OutofPocket.com as a tool to help them compare costs and find out what other consumers paid for similar services.  "Providers are often willing to negotiate, with both insured and uninsured patients and those whose insurance only covers a portion of their health expenses", says Jonathan Pletzke, author of "Getting a Good Deal on Your Health Insurance Without Getting Ripped Off."

Paying cash up front helps consumers save money because providers do not have to process billing and insurance forms, and are often willing to discount prices in return for payments at time of service. 

Be sure to compare costs before purchasing health care services.  The more you know, the better informed you will be to negotiate a fair price for services.

If you think you were overcharged for health care services, you should contact MYINSNET.com, an insurance negotiating service that offers consumers assistance in negotiating medical claims.   This company states they have saved insurance companies millions of dollars and an average savings per claim is about 25%.  The same techniques and resources they’ve used to save insurance companies money are now available for individual consumers.  Any patient with a medical bill greater than $200 is eligible to send their bill to INSNET for negotiation.  Consumers can use services such as INSNET to determine if the amount they paid for health care services is reasonable.  If the charges are deemed excessive, INSNET will attempt to negotiate directly with the provider and INSNET charges a fee based on the amount saved on the patient balance.  There is not risk for consumers because they charge no fee if there is no savings.   When you visit the MyInsnet, be sure to indicate you heard about their service on OutofPocket.com and they will offer you an additional savings.

 

Bottom Line Secrets published an article several years ago on tips you can use to fight back if you think you are being overcharged for health care services.  This article was recently brought to my attention because this information still applies today.  Here is a brief summary of some of the tips.

To avoid paying more than you should for doctor bills

1. Remember to negotiate.  Try asking your doctor for a discount. 
2. Have blood tests done at a lab, rather than at your doctor’s office. 
3. Don’t pay for follow up visits. 
4. Ask your doctor if tests prescribed are necessary. Doctors often order unnecessary diagnostic tests including MRIs, CAT scans and X-rays. Ask what these tests will determine.

Tips on how to spot over billing on hospital bills

1. Request a daily itemized bill. 
2. Avoid using the hospital pharmacy.  Have your prescriptions filled at your local pharmacy.
3. Watch out for double billing and review your bill detail carefully.
4. Don’t pay for the last day at the hospital if you are discharged before noon. 

A recent article, Click here for the best health care, offers some very practical advice on how consumers can make smarter decisions when selecting doctors and hospitals - and how to plan ahead for medical expenses. 

Selecting the right doctor

Consumers can find out about a doctor's experience and a hospital's success rates, and even find information on what these services cost.  First, get to know your doctor.  Do some research to find out what other patients have to say about the doctor.  Personal recommendations carry a lot of weight and people trust what other consumers have to say.  Check if your doctor is board certified.  Search the American Board of Medical Specialties to find out.  Make sure your doctor has done this procedure before.  Use Vitals.com to find out how many times a doctor has performed certain procedures in a year, and look up historical data to determine if there are any sanctions or malpractice claims.  If you cannot find this information on public sources, call the doctor’s office and ask. You want a doctor that has lots of experience.  Know the price before you visit the provider.  If you have out-of-pocket expenses, it’s well worth your time to call your doctor and your insurer to determine the amount you are responsible for.

Selecting the right hospital

Hospitals provide a lot more performance data.  Just like doctors, hospitals get better with experience.  You can use Vimo.com to find out how many times a hospital has performed a procedure.   RevolutionHealth.com also provides similar information.  HealthGrades is an excellent source of quality ratings for hospitals. You can purchase a report from HealthGrades to obtain cost and quality information. 

I am pleased to announce the new release of OutofPocket.com, version 2.0.  Our new search engine enables consumers to look-up prices for health care services, and allows providers to list their prices/services in the directory - free of charge.  In addition, the search engine features expanded search technology and searches for health care price data across other public price transparency tools.

I welcome all your feedback and comments on this new release and I would appreciate if you could help us spread the word.  As you know, the more people that contribute and use this tool, the more powerful it will become for everyone.

Thank you for all that you do to help promote health care price transparency. 

NEW FEATURES IN OUTOFPOCKET.COM VERSION 2.0

 

(1) Enhanced search engine provides more relevant search results

(2) Easy for consumers to post/share their own visits and prices they paid for services

(3) Comprehensive search results - searches other websites that publish pricing and websites that offer price transparency tools

 

PRICE DATA COLLECTED FROM MULTIPLE SOURCES

 

·         Providers can submit price lists for their services

·         Consumers are invited to post/share prices they paid for actual visits, along with their personal recommendations on the provider

·         Claims Data from Businesses, Health Plans or TPAs

·         Government CMS Medicare payment data

·         Websites that publish prices for health care services including hospitals, diagnostic testing facilities, clinics and physician practices

·         Price Transparency Tools on public websites including health plan tools and state price transparency tools

 

BENEFITS for BUSINESSES

 

·         Load your claims data into OutofPocket.com to enable your employees to search for their true out-of-pocket costs for specific service

·         Employees can use OutofPocket.com to search for prices for specific services in your network plan

·         Encourage employees to collaborate and post prices they paid for health care services, to share these good deals with other employees

·         Eliminate providers that overcharge - Use OutofPocket.com to direct your employees to affordable, low-cost providers

·         Avoid providers with poor performance by encouraging employees to share recommendations on provider visits

 

BENEFITS for CONSUMERS

 

·         Look-up prices, comparison shop and find the best value for routine health care services in your neighborhood

·         Tool makes it easy for you to post/share prices you paid for actual services with other consumers

·         Share your recommendations on a specific provider with other consumers

 

BENEFITS for PROVIDERS

 

·         Add your true prices/services to the directory – free of charge

·         Consumers can easily find your services and link to your website

·         Include additional information about your practice, services

·         Search results links directly to your website

·         Provides additional exposure for your services

 

 

The California HealthCare Foundation (CHCF) offers some great tips for consumers that are interested in comparison shopping for non-emergency hospital services.    The consumer tips provided by the CHCF are based on the results of a recent mystery shopper study conducted at 64 California hospitals.  Here are some of the highlights, but be sure to visit their site to read all the tips. Most important, be sure to ask the right questions before using hospital services.

 

1.     Call first.  Consumers should call a hospital to obtain pricing information, rather than wait to ask for pricing in-person.

 

2.     Know the CPT or ICD-9 code.  This is the specific American Medical Association (AMA) code assigned to each medical procedure or service and is used for billing purposes.  It’s actually a lot like a specific part-number for an electronics you purchase.   When you know the specific code (part number), you can compare apples-to-apples.  Once your doctor has explained the service or procedure you need, ask your doctor for the CPT code.  It will save you time and money.

 

3.     Ask about a discount.  If you don’t ask, it almost certainly won’t be offered.  Find out how much and under what conditions discounts apply.  You might find that paying by cash or using your credit card entitles you to discount.

 

4.     Find out what’s included.  There’s little consistency among hospitals in terms of the type of prices quoted, making applies-to-applies comparisons difficult.  You should ask as many questions as necessary until you are comfortable with the information about what specific services are included.  If you are not getting the answers you need, ask to talk to someone in Admitting, Financial Counseling, Billing or the Cashier’s Office.

A recent article in RNcentral.com provides 25 tips on how consumers can save money on health care services – even if you do not have health insurance.  Here is a brief summary, but be sure to checkout the entire article for additional information and helpful resources. 

Medical Care

• Take advantage of walk-in clinics
• Consider alternative therapies 
• Try using a nurse practitioners instead of a doctor
• Research medical tourism
• Check out a health fair for free routine screenings
• Volunteer for medical school clinics
• Use phone medical services for less complicated issues
• Avoid the weekend
• Review your bill for errors
• Negotiate your bill

Prescriptions and Equipment

• Shop around and compare prescription prices using resources like Consumer Reports, the AARP or the Medicare Rights Center
• Buy store brands for over the counter medications
• Request generic prescriptions
• See if you qualify for freebies 
• Double up on medication
• Cut your medications in half 
• Get creative. Work with your doctor or pharmacist to see if you can't find a lower cost solution to your prescription drug costs
• Reuse and recycle. Friends, neighbors or even a church group may have equipment that can suit your needs at a greatly reduced cost 
• Shop for frames at retail stores or large chains instead of the eye doctor’s office