In Wisconsin on Januray 1, 2011 patients have a right to information about charges, insurance payments, and out of pocket costs for the most common types of care at clinics and hospitals. Under Wisconsin Act 146 patients have a right to know a good faith estimate of the total out of pocket cost for a specified medical service. The bill states any good faith estimate provided is not a legally binding estimate.
Wisconsin Act 146 involves the transparency in all health care pricing, which is legislation sponsored by Representative Steve Kagen (D-WI), a physician. This legislation begins publication of pricing for services by hospitals, physicians, nursing services, pharmacies, drug manufacturers, dentist, and insurance providers. Legislators agree this is information consumers need to make informed decisions on health care spending.
The pricing information is only provided if the patient requests it. The insurance provider will ask the patient to submit the name of the provider performing the service, the name of the facility where the service will be delivered, the date the procedure is scheduled, and a procedural terminology code.
Tied to the publication of the actual cost will be lead indicators of the quality of the service performed. Information will indicate how successful the health facility is in meeting quality bench marks that indicate positive outcomes for the patient receiving the service.
The driving force is the consumer populations recognition that prices charged for an identical service can vary by thousands of dollars depending on the health facility performing the procedure. Consumers began to note that higher prices did not always translate to better service, or improved outcomes.
Home Care Path www.homecarepath.com reminds seniors that in Wisconsin they can request the out of pocket cost for a provider ordered service prior to receiving the procedure.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment