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Engaging Patients:

Price Transparency

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On June 24, President Trump signed an Executive Order on Improving Price and Quality Transparency mandating hospitals to publicly post standard charge information. 
 
Hospitals face two requirements:
  • Display a Machine Readable, publicly-available list of charges with negotiated and payer-specific discounts, and
  • Provide a user-friendly app or website for patients and guarantors to get estimated costs for “shoppable services”.
  • Deadline:  January 21, 2021

 

Dynamic Health IT (DHIT) features an easy-to-use web site for your consumers and prospective consumers that can help market your services while meeting the requirements for the new Price Transparency regulations. 

 

  • Branded with your logo

  • Prospective patients can view their “Estimated Out of Pocket Cost” based on:

    • Selecting a “shoppable service”

    • Entering their insurance total deductible and how much they’ve met so far

    • Entering their co-pay and co-insurance amounts

  • Option to customize contact information with users next steps: make an appointment, more information needed, hospital contact phone and website

  • Redirect to the hospital website

  • Optionally collects patient demographic and contact information

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Allows you to upload the following:

 
  • Your chargemaster, list of payers, and payer-specific discounts.
  • The CMS list of “shoppable services” is pre-listed and you can use them or add your own.
  • For each shoppable service, you can select one or more charge codes and each charge code can have a quantity.
  • Payers can have across-the-board discounts or item-specific discounts, or a combination of the two

Frequently asked questions

True or False: Each item/service provided by the hospital must have all five types of corresponsing standard charges?


False. The requirement is that a hospital post the standard charge as applicable for each item/service the hospital provides. For example, your hospital may provide itemized services (as found in your hospital chargement) that only have corresponding gross chargesa but do not have corresponding payer-specific negotiated charges. Similarily, your hospital may pprovide service packages that have corresponding payer- specific negotioted chares but no corresponsing gross charge.




True or False: The Hospital Price Transparency Final Rule requires hospitals to calculate the historical average reimbursement by payor in order to be able to post the payer-specific negotiated standard charges.


False. The payer-specific negotiated charge is defined as the charge that a hospital has negotiated with a third party for an item or service. For each third party payer whom your hospital has negotiated charges, you should consult your contract and rate sheets to identify and collect the data elements that are required (as applicable) for display.




True or False: All hospital items and services are found in the hospital chargemaster,


False. Hospitals must post the standard charge (as applicable) for each item/service the hospital provides, This would include items/services that are provided as 'service packages'. An example of a 'service package' could be a procedure or 'per diem'. Such items/services are not found in the chargemaster because the chargemaster is a list of itemized items/services (not service packages).