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The latest in hospital care: An estimate up front

July 27, 2017

You expect it from your car mechanic - now you can get it from your hospital as well.

An up-front price estimate, that is.

It's trending nationally, and now getting an estimate of your likely out-of-pocket costs from the provider of choice is a service UHS is happy to offer right here in Greater Binghamton.

Over the past several months, UHS' Revenue Cycle Team has been helping patients who are scheduled for an upcoming surgery at UHS Wilson Medical Center or UHS Binghamton General Hospital to identify the costs that health insurance won't cover.

And team leaders say the service will be expanded this summer to include surgery at UHS Chenango Memorial Hospital and, later this year, to more clinical areas, such as the Emergency Room, Radiology and Outpatient Laboratory, across UHS.

"Out-of-pocket costs are balances the patient owes which were predetermined by the employer and the insurance company for each healthcare service," said Tami Miller, manager of Access Care at UHS. "These costs include co-payments, deductibles and co-insurance balances, which could amount to thousands of dollars, depending on the service."

She said many people don't think about out-of-pocket costs until the bills start arriving. Then, their emotions can run from shock and anger to frustration and anxiety.

"Our goal on the Revenue Cycle Team is to help reduce those feelings by proactively informing the patient about the costs prior to or at the time of service," Ms. Miller said.

Having surgery can be a stressful experience. If the patient can be assured that they are in good hands financially as well as medically, the stress can be eased, she noted.

"We don't want the medical bill that arrives 30 to 60 days later to put a damper on anyone's recovery," she said.

National statistics suggest that people are often disinclined to pay medical bills, at least in part because the invoices come as a surprise - no one informed them of the out-of-pocket costs or how they could set up a payment plan for them.

UHS strives to inform and educate patients in advance of any surgeries or procedures about what to expect as a result of the care, both clinically and financially. So far this year, UHS staff have given estimates to more than 1,600 patients, explaining how their insurance benefits will be processed and helping many to arrange payment options.

Patients who receive an up-front estimate during a financial discussion prior to a procedure will often pay all or part of the bill up front as well.

UHS also offers an online bill-payment tool, with patients able to receive e-mails and pay remaining balances online. Text-messaging alerts about open balances will be added this summer.

"Our role is to inform, educate and assist our patients with these out-of-pocket balances," Ms. Miller said. "Stabilizing the revenue flow to the hospital ensures that we can continue to furnish our community the best possible facilities, equipment and clinical professionals to provide care."

Patients who would like to discuss a price estimate for care they anticipate can call Access Care at UHS at 338-1211.