Is it Possible to Find Out What Surgery Will Cost Before the Surgery?

Healthcarebluebook.com, a leader in helping patients obtain fair prices for medical procedures, surgeries and treatments, wants to know if it is possible for patients to find out what surgery will cost before the surgery. So, as part of Healthcare Blue Book’s ongoing effort to learn more about how patients can obtain pricing before agreeing to a surgery, their researchers regularly conduct pricing studies with medical providers.

In a recently published white paper, Surgery Pricing Secrets: The Challenges Patients Face, Healthcare Blue Book queried hospitals and Ambulatory Surgery Centers (ASCs) in three demographically disperse markets. These were Raleigh-Durham, North Carolina; Denver, Colorado; and Portland, Oregon. Researchers sought to obtain prices for self-pay patients, who did not intend to use insurance to pay for the procedure.

Healthcare Blue Book research focused on the ease of obtaining a price quote from a facility prior to receiving treatment. The evaluation included several categories, including how to:

  • Find someone who could answer pricing questions
  • Get a price quote within a reasonable amount of time
  • Obtain a complete price quote for all parts of a surgery
  • Ask for and obtain a cash discount
  • Get a guaranteed price estimate

The researchers found that while many hospitals attempt to help patients figure out what surgeries will cost, it’s still uncommon to obtain guaranteed prices from them before a surgery. Although many hospitals have created a staff position called “patient financial counselor,” patients frequently have a frustrating and unproductive experience. In contrast, ambulatory surgery centers (ASCs) provide far greater pricing transparency to patients and do so in a patient friendly manner in most cases.

The primary conclusion reached from the research is that healthcare pricing transparency is not possible under the current practices and pricing policies of most hospitals and some ASCs.

Healthcare Blue Book suggests six steps consumers can take to make sure they get a fair price for their surgery:

1. Ask your surgeon for the CPT code for your procedure before researching surgery pricing.

2. Call multiple providers from different types of facilities.

3. Ask for all costs associated with a surgery (surgeon, facility, anesthesia, hardware, etc).

4. Get pricing estimates in writing.

5. Consider out-patient alternatives to hospitals whenever possible.

6. Be patient and persistent when conducting pricing research.

The Healthcare Blue Book is provided free to consumers. The Healthcare Blue Book price represents a fair price to pay for a service or product when the patient is paying cash at the time of treatment. It represents a payment amount that many high-quality providers accept from insurance companies as payment in full, and it is usually less than the stated “billed charges” amount. Visit www.healthcarebluebook.com.

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