Healthcare Provider Cost Estimating Tools

Part
01
of two
Part
01

Tools for Comparing the Prices of Health Care Services

Detailed research reveals that some major competitors of Baylor Scott and Whites include Porter Health Care Systems, Chino Valley Medical Center, Ascension, Texas Health Resources, Ascension, HCA Healthcare, etc. The tools used by the identified competitors of Baylor Scott and White's to help patients compare prices for health care services include web platforms and brochures, among other resources. The methodology used to identify the competitors of Baylor Scott and White's, as well as the tools utilized to help patients compare the prices for health care services are as follows.

METHODOLOGY

Our research team scoured through several comparative analysis databases such as Hoovers, and Owler to identify the competitors of Baylor Scott and White's. The websites of the various competitors were then scoured through along with recent press releases and healthcare industry reports in an attempt aimed at unearthing the tools they use. We prioritized first-hand information obtained directly from the competitor websites over third-party websites to uncover the tools used to help patients compare prices for various health care services. Our discoveries from the above procedure are as follows.

1. PORTER HEALTH CARE SYSTEMS

The web tool known as MD Save used by Porter Health Care System is accessible via this link.

Porter Health Care System uses a web tool known as MD Save to list average pricing for health services. Porter Health Care System also offers a detailed price list of medical procedures through MD Save that allows patients to compare pricing. The MD Save web platform allows patients to find procedures across the United States and buy their procedures sometime saving up to 60%.

MD Save allows patients to compare local prices and search through a network of over 180 hospitals and care providers and compare the prices for about 1,300 procedures. The advertised bundle prices usually include all associated fees. Through MD Save, patients can buy their medical procedures and pay for such procedures in advance through a secure website or just by calling a support specialist and also schedule visits with a doctor. Patients are required to bring a copy of their purchase voucher to an appointment as proof of payment for procedures. The procedures advertised by MD Save include plastic surgery, among other medical procedures.

2. CHINO VALLEY MEDICAL CENTER

The web tool (New Choice Health web platform) used by Chino Valley Medical Center to provide medical procedure price comparing solutions for patients is accessible via this link.

One of the platforms (tools) used by Chino Valley Medical Center to provide medical procedure price comparing solutions for patients is the New Choice Health web platform. New Choice Health web platform allows patients to compare the prices of different providers for procedures like myomectomy, hysterectomy (cesarean section), etc., across the United States. Free quotes are also available upon request.

Other health care service prices provided by New Choice Health web platform include ankle replacement surgery, arthroscopic knee surgery, arthroscopic shoulder surgery, colonoscopy, endoscopy, among other medical procedures.

3.ASCENSION HEALTHCARE

The web tool (Florida Health Price Finder) used by AscensionHealthcare is accessible via this link.

AscensionHealthcare utilizes Florida Health Price Finder web tools to offer pricing transparency solutions for a broad category of medical procedures. The Florida Health Price Finder located at https://pricing.floridahealthfinder.gov assist patients in finding and comparing data on health care costs at the national, state, and county levels.

The pricing solution of Florida Health reveals the average payments paid for health plans across over 200 service bundles. These bundles include payments made to physicians, hospitals as well as ancillary services. The tool allows patients to gain insights into health care pricing/costs across several areas including knee replacement.

4. JPS HEALTH NETWORK

The website of JPS Health Network is accessible via this link.

JPS network has a health services and pricing tool that cover popular inpatient and outpatient procedures. The pricing solutions offered by JPS reveal out-of-pocket costs and does not indicate any discounts that are available to some patients. The pricing services of JPS Health Network cover a wide range of health procedures including mammograms.

5. HCA HEALTHCARE

The brochure and Centers of Excellence (COE) program of HCA healthcare used to provide a variety of pricing options for patients is accessible via this link. A screenshot of HCA Healthcare pricing web platform is also accessible via this link.

HCA has made pricing and financial information available to patients online since 2007 to help them in making informed healthcare decisions. HCA Healthcare utilizes a platform known as Centers of Excellence (COE) to offer health care procedures at comparatively low costs to its members. HCA has forms available online.

Part
02
of two
Part
02

Recondo - Healthcare Cost Estimator

ClaimStatusPlus™ is the most popular healthcare cost estimator tool provided by Recondo. Their clients use it to interact with patients/payers, gain quick access to the entire inventory, get rid of their backlog of patient claims, and for their point-of-service collections. They also use it as a replacement to book pricing codes and to modernize their patient estimation process through automation. Below is a deep dive into our research.

General insight into the use of recondo's healthcare cost estimator tool

Recondo's tools include ClaimStatusPlus™, SurePayHealth™, Auth-DP™, and Recondo’s BeneftsPlus™. Their tools can be used to increase the productivity of staff, lessen the time for processing patient claims, increase collections pre-service and post-service, increase revenue for companies, encourage patients to pay upfront, and also keep patients satisfied based on efficiency, reliability, and accuracy.

Recondo partners with several tech companies and works with over 4,500 organizations spanning from regional hospitals to Integrated Delivery Networks to specialty practices. Bons Secours, the University of Colorado Health and Stanford Health Care, St. Jude Children’s Research Hospital, USC Health, Banner Health, Stormont Vail and Ensemble Health Partners are all new customers for Recondo due to the reputation it has set in the industry, especially for the touchless claims using the ClaimStatusPlus™. By using the ClaimStatusPlus™ tool, hospitals have been able to recover aging accounts and have benefited from increased revenues via point-of-service collections after using Recondo SurePayHealth™.

Specific examples of clients using Recondo's cost estimator tools

Queen's Medical Center

The Queen's Medical Center replaced their Claims Status Quo with Recondo's ClaimStatusPlus™ and have reaped the benefits compared to their previous process which required manual checking of inventories. They use it to gain quick access to the entire inventory database and determine its status while also identifying the "claims that require manual intervention". They also use Recondo's ReconBot™ to interact with patients/payers, work directly with payers, and maintain the patient-company relationship. Using these tools has helped them to cut back on write-off from $2.7 million to $92,000, representing a 96% recovery. This brought about an increased cash flow of $5 million.

Avera Health

Avera Health experienced an increasing backlog in handling patient claims, but Recondo's ClaimStatusPlus™ was used to alleviate this problem. They used this tool to revamp their claim verification process as it relates to those being approved or denied, which helped them to get rid of patient claims backlog. They shifted from manually checking over 13,000 claims per year, making phone calls, and checking payer's website to a fully automated system for finding out the status, verification, and increased productivity for staff. Using this tool has helped them to reduce aged accounts by 52%, preventing the company from needing to hire 5-7 Full-Time Equivalents, and improved cash flow by $2.1 million.

Mercy

This company utilized Recondo-Epic Integration for their point-of-service collections which led to an increase in their collections and recommendations for hospitals to use Epic Benefit Collector. The use of Recondo’s BeneftsPlus™ has significantly helped Mercy to achieve an increased collection of 12%, reduced the time to process patients, and increased accuracy. Mercy has used Recondo to gain accurate statements for patients via insurance eligibility verification, which leads to the provision of better information for the patients who are more likely to pay upfront when they are fully aware of the cost they have to pay on their own.

Atrium Health (Carolinas HealthCare System)

Recondo's SurePayHealth and Auth-DP™ was used by Atrium Health which saw them earning $1 million in pre-service collections alone. Atrium has used Recondo to provide an automated system that controls patient access rather than delegating highly skilled staff or having limited services to facilitate the same. They used it to reduce denied accounts and dollars, and also replace the need for manual intervention. They used Recondo to replace their book of pricing codes and another inefficient patient accounting system. Now, the company is able to get all information relating to prices, patient's accounts with little manual labor and greater efficiency. They reduced the number of staff required for manual assistance to patients from 100% to 20%.

St. Francis Hospital

St. Francis Hospital used Recondo's SurePayHealth™ to avoid the use of manual estimates for patients. Now they are using an automated pricing system which has resulted in a 37% increase in collections. They have used Recondo to modernize their patient estimation process through automation which has helped the company to provide accurate information to patients prior to surgeries so that payments can be made. They also use it to replace the use of a spreadsheet system to track payers.
Sources
Sources

From Part 01
Quotes
  • "FIND PROCEDURES IN THE UNITED STATES Buy your procedure and save up to 60%"
  • "COMPARE LOCAL PRICES Search our network of 180+ hospitals and providers and compare prices for over 1,300 procedures. Our bundled prices include all related fees."
  • "BUY YOUR PROCEDURE Pay for your procedure in advance through our secure site or by calling our Support Specialists at (888) 787-0902. That’s it — no more bills."
  • "VISIT THE DOCTOR Follow the scheduling instructions for your selected provider. Bring a copy of your purchase voucher to your appointment as proof of payment."
Quotes
  • "At Florida Health Price Finder (https://pricing.floridahealthfinder.gov), you'll find data on health care costs for national, state, and county prices."
  • "https://pricing.floridahealthfinder.gov., shows average payments made to health plans for more than 200 service bundles. The bundles nclude payments to physicians, hospitals and ancillary services."
Quotes
  • "The Centers of Excellence (COE) Program offers knee and hip replacement surgery and spine care for low to no cost to qualifying Uniform Medical Plan (UMP) Classic and UMP CDHP members."
  • "Through the COE Program, HCA contracts with providers who excel in treating certain medical conditions. These providers are selected to be a part of the COE Program because they have proven their ability to provide excellent service with successful results for patients with those conditions. Virginia Mason is the COE for knee and hip replacement surgery. HCA selected Capital Medical Center and Virginia Mason as the COEs for spine care. Premera Blue Cross administers the COE Program."
Quotes
  • "Services & Pricing Below is a list of common inpatient and outpatient procedures. Prices represent estimated out-of-pocket costs. The list below does not include any discounts that may available to you."
From Part 02