Healthcare Price Transparency
Helping you with price transparency final rule compliance
Listen in as Jaime Cleverley, President of Cleverley + Associates, and Riley Matthews, Lead Product Manager at Experian Health, discuss how a new partnership is helping providers comply with the Price Transparency Rule.
What is the Price Transparency Final Rule?
Price transparency is an over-simplified term. While the OPPS Price Transparency Final Rule (CMS-1717-F2) marks an escalation by regulators to influence a consumer-friendly (and familiar) experience, there is much more opportunity to make patient engagement truly “friendly.”
We know consumers overwhelmingly want to understand the cost of healthcare services, prior to services being performed. Transparency, beyond being regulatory requirement, is a significant improvement to the patient journey - benefiting not just the patient but the provider, which typically sees improved collections and patient satisfaction.
Want to get started? Connect with our team and evolve the patient experience to a seamless consumer experience today!
Unpacking the No Surprises Act: How will it impact the provider workflow?
Watch the on-demand webinar
Vanessa Carter, Pre-Service Center Manager at St. Joseph's/Candler, discusses how they use Experian Health Patient Financial Advisor to provide patients with estimates for services before their visit.
Overview of the Final Rule requirements
The final rule mandates that hospitals must publish the following by January 2021:
Consumer-friendly, searchable list displaying the payer-specific rate for 300 shoppable services
"Shoppable" is defined by CMS as a service that can be scheduled in advance. CMS has already specified 70 services. If you want to read more about the final rule or view the CMS list of 70 shoppable services, click here. Shoppable services can be found on page 190, Table 3.
A comprehensive machine-readable file for “Items and Services” offered by the hospital
The standard file must include:
- Gross charges
- Cash price for self-pay
- Payer-specific negotiated charges
- De-identified minimum/maximum negotiated charges
Patient Estimates
User-friendly, web-based estimates of authorized services for patients before or at the point-of-service.
PatientSimple™
Secure online portal, giving patients the 24-7 control they’re looking for over their healthcare accounts.
Eligibility
Experience fewer payment delays, less confusion, and minimal need for follow-up with POS eligibility solutions.
Patient Financial Advisor
Offer real time estimates and secure payment methods with your patient's benefit information, payer rates and provider pricing in mind.
Three ways hospitals can support price transparency
Road to price transparency in healthcare
Learn how you can meet the needs of the upcoming OPPS Price Transparency Final Rule (CMS-1717-F2), specifically the shoppable services portion of the mandate in this on-demand webinar.
Blessing Health System: Automated estimates
Blessing Health knew they needed to find a way to advise patients of their financial liability, as well as give staff a tool they could confidently use to request patient payments upfront to increase collections.
Success at a glance: Silver Cross Hospital
With Self-Service Patient Estimates, patients of Silver Cross Hospital now have a consumer-friendly, easy-to-use and accessible path to obtain out of pocket cost estimates.
How to add transparency to your billing process
All in, transparent pricing is an increasingly useful strategy to improve revenue alongside patient satisfaction. So, how should providers be using transparent pricing to improve the patient experience?
We welcome the opportunity to provide you more details.
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