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Federal Requirement for Hospitals to Show Pricing Launches in 2019

December 26th, 2018 - In Healthcare, Insurance News

In the new year, 2019, a federal requirement will require hospitals to show the goods, so to speak. In other words, pricing for services the hospital provides will become accessible for the public.

It’s a small win for patients. But the question remaining is how on point are the shared prices? Let’s take a look.

There is a set of prices the hospital lists for everything. This list is a charter of sorts, but it’s not entirely accurate once insurance comes into play. Each policy will have its own negotiated pricing structure, plus demand for co-insurance for its client. Hospitals know that the outlandish prices they’ve posted on this charter are almost always never met in their entirety, so there’s a lot written off on the backend.

Will patients be able to “shop” the best price between a hospital? Technically, yes.

They will at least have a vague idea of the starting point. However, without knowing the medical codes and procedures necessary, it will not exactly be easy to look things up for an emergency. Nor will you be able to obtain an official final tally, or probably anywhere close to one. Lastly, if you’re experiencing an emergency like stitches or a potential broken limb, the last thing you should be doing is deciding on which hospital charges the least for the services you think you’ll need. Your main purpose should be to get medical attention as soon as possible.

Could patients who have a planned procedure benefit from this? Possibly, if they have to have an in-patient procedure and their doctor has rights at multiple hospitals, the doctor’s bill staff may be able to give them codes to look up to get a better idea. However, their insurance provider will still be the ultimate say on how much they will cover and to where they will cover it.

To read more about this new federal requirement for hospital pricing, visit: www.ajc.com/news/national/hospital-prices-are-about-public/2jXYHgoR5CObBj6fSJQQUO.

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