Medical Cost Transparency Massachusetts
 

Once again the progressive legislators in Massachusetts have moved the health care industry a bit more in the direction of helping the consumer.

Price Tags On Health Care? Only In Massachusetts - Kaiser Health News

For those unwilling to click on links.. part of the article

Anyone with private health insurance in the state can now go to his or her health insurer’s website and find the price of everything from an office visit to an MRI to a Cesarean section. For the first time, health care prices are public.
(T)wo years ago, Massachusetts passed a law that pushed health insurers and hospitals to start making this once-vigorously guarded information more public. Now as of Oct. 1, Massachusetts is the first state to require that insurers offer real-time prices by provider in consumer-friendly formats.



Here are some details of the early implementation in a link to the Mass. Medical Society. There is a requirement that your doctor provide you with the CPT codes that will be used to bill the insurance company to help you find the cost.

What Physicians Need to Do
•Provide the patient with the CPT codes for all anticipated services and procedures. Patients will provide those codes to their health plan to obtain the contracted costs for the professional services, facility fees, and out-of-pocket costs related to the request.

The law states that if asked by a patient, a health care provider must disclose the allowed amount or charge of the admission, procedure or service, including the amount for any “facility fees” required within two working days. The law defines “allowed amount” as the contractually agreed amount paid by a carrier to a health care provider.

The law also compels providers who participate in networks to provide “sufficient” information about the proposed procedure or service to allow a patient to use the network’s toll-free telephone number and website established to disclose costs.


Massachusetts Medical Society: Massachusetts Medical Price Transparency Law Rolls Out

This is a big win for patients who now can plan knowing their costs. Not surprisingly there are huge differences between doctors and facilities in charges, and in allowables. So if you knew that a chest Xray at one place was $35 and ten miles away it was $75 would you drive the ten miles to save the difference if you were self pay? Would you drive it if your insurance were going to pay the cost?

http://www.tuftshealthplan.com/visit...WT.mc_ev=click

Here is Tufts Health Plan description of the information they provide, and click on the link at the very bottom for example screen shots
http://www.tuftshealthplan.com/pdf/e...me-screens.pdf

That is definitely some good news finally in the health care world. Never did understand why those codes are such a secret. Recently had a billing problem with some blood work and when I called Quest I asked for the codes they used to bill me. The person I was speaking to said she couldn't give them to me cause she was not a trained medical person. I said all I want are the numbers and she absolutely would not give them to me. So I definitely see this as a step in the right direction.