Want to price shop for medical procedures? 5 steps for patients to get started
Patients can avoid sticker shock and bill surprises by pricing out their medical services and procedures ahead of time.
Hospitals are required to publicly post a consumer-friendly list of prices, and many offer price estimator tools that allow patients to get personalized estimates.
But many consumers may not even know these tools exist. Here’s how to use hospitals’ public pricing information to your advantage. You can use the tools to price out a procedure before you have it done, or to cross-check your medical bill afterward.
More:Finding hospital prices can be complicated for patients, even with transparency rule in play
1. Figure out where you want to look up prices
Start by figuring out where you may want to have a procedure done. If you get all your medical care through a particular health system, you may want to start there.
From there, you may want to choose a few other hospitals in the area to compare prices and see how closely they align for a given procedure.
For the Oklahoma City area, here are links to price estimator tools for each of the four major health systems:
2. Gather your insurance details
Next, if you have insurance, find your insurance card.
You’ll want to have your ID number, group number and insurance plan name handy, along with your name and date of birth.
Some price estimator tools will be able to use your insurance details to look up how much you’ve spent toward your deductible and your out-of-pocket max. But it’s helpful to have those two numbers handy, as well, so you can cross-check, and because some tools will ask you to enter it yourself.
You may need to log in to your insurance provider’s website to find that information.
If you don’t have insurance, you can still use price estimator tools: You can select an uninsured option on hospitals’ price estimator tools.
3. Pick what procedure you want to compare
Figure out what service or procedure you want to look up. Most price estimator tools will let you browse the services they have listed.
Not all procedures and services may be included in hospitals’ price estimator tools. The Centers for Medicare and Medicaid Services requires that hospitals include these 70 shoppable services, plus at least 230 other services of their choosing, for a total of 300 minimum services.
This document has a list of the 70 services required to be included (starting on page 4), along with codes that you can use in price estimator tools for easier searching.
4. Start shopping
Once you have all of your information gathered and you know what procedure you want to look for, start digging into the price estimator tools.
Each time you get an estimate, we recommend jotting down the price or printing a copy of the web page so you can compare it to other prices as you go.
Keep in mind that hospitals' estimates may not include costs like physicians' fees or charges for other professional services.
5. When in doubt, call with questions
Can’t find the service or procedure you are looking for, or are you struggling to use your hospital’s price estimator tool?
OKC’s four major health systems each have phone lines to help patients get more information on pricing and can offer personal assistance in getting a cost estimate.
Here’s how to reach each one:
SSM Health: 844-989-6292
Mercy: 855-420-7900
OU Health: 405-271-3546, ext. 13546
Integris Health: 405-713-4500 or toll free at 877-313-4500, or also by email at consumerpriceline@integrisok.com.
This article originally appeared on Oklahoman: 5 steps for patients to start price shopping for medical procedures
