Price Transparency – Simplified
Clarity for Patients, Compliance for Healthcare Systems - Transparency for your Organization
CMS 1717-F2 – can you afford an audit? Everyone had a year to prepare, Center for Medicare/Medicaid Services (CMS) is now conducting audits and they’re not issuing hardship waivers or exemptions! Civil monetary penalties of up-to $300 per day can add up fast.
The CMS ruling on price transparency requires providers and payers to disclose more details about the fee schedules and payor contracts that affect charges to patients. Fee schedules and contract rates must now be published and must be made accessible to all patients and potential patients.
However, just having access to rates is of limited use because the final costs to the patient is not determined by gross charges, but rather by what contract rates have been negotiated between providers and the payers, as well as the patients plan benefits.
In order for the transparency solution to be truly effective, the patient must be able to identify their specific insurance and also select the type of procedure(s) they will require. Most systems don’t help patients line up this information – ours does.
Check List:
- Have you published your organizations total gross charges, payor specific negotiated rates, de-identified min/max negotiated reimbursement, and your self-pay discounted cash price?
- Are you letting patients know the common services you provide?
- Is your publication of this information in one of the approved formats?
- Have you gone above and beyond to provide patients with real-time estimations?
Here’s the Point
Don’t simply publish your rates under CMS 1717-F2. Healthcare systems and hospitals need to make their fee schedules and supporting data actually useful for patients – and that takes a little extra effort. That effort will manifest as excellent customer service, which will encourage individuals to select your hospital as their provider.