RCM tip of the day: Use online estimators for price transparency

Hospitals should use online estimator tools to help patients understand their potential out-of-pocket costs, advised Kevin Smith, vice president of product management at nThrive, a revenue cycle management company.  

Effective Jan. 1, CMS will require hospitals to publish a list of their standard charges on the internet. They must present the information in a machine-readable format that can be easily imported into a computer system and update the information at least annually.

The CMS price transparency rule initially focuses on publicizing the chargemaster, but it will not necessarily provide patients the information they're looking for, Mr. Smith warned.

"The patient is not going to understand anything published in a machine-readable format from a chargemaster," he said, noting that a CT scan, for instance, may be performed with or without contrast.

He added: "There will always be potential extras, including supplies, drugs, etc. We recommend that healthcare organizations utilize a patient facing estimator tool, which is much more consumer-friendly."

Mr. Smith said healthcare organizations should also post a disclaimer with standard charges, so patients know they are viewing a list price that may not reflect their actual out-of-pocket costs.

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series. 

 

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