Price Transparency, Payment Expectations, and Payment Terms
Objective: Price Transparency
Participants in the Patient Friendly Billing project believe that price information provided to consumers must be meaningful to them. Meaningful price transparency ideally involves a patient having the ability to get an estimate--prior to service--of the amount the patient will actually owe for the treatment, and that estimate incorporates the patient’s specific condition and insurance coverage.
Such estimates from several providers, coupled with information about each provider’s quality of care, would allow patients to make meaningful decisions about the value of care from each provider. Ultimately, the objective is to provide patients with easy and timely access to information that clearly explains their financial obligation to pay for health services--in most cases, in advance of receiving those services.
Objective: Payment Expectations and Terms
Have patients and providers work together to agree on appropriate payment expectations and terms of payment.
Related Case Studies and Tools
Systems that have transparency in action are working to achieve meaningful price transparency and to agree with patients on setting payment expectations and payment terms.
- Geisinger Case Study
In most cases before the point-of-service, Geisinger successfully gives patients estimates of their financial obligations and works with patients to agree on payment expectations and terms. Learn more about how Geisinger improved patient satisfaction and achieved an ROI of over 200% through the MyVisitsm Program.
- Case Study of Another Health System
This health system successfully provides to almost 2,000 patients each month estimates of their expected financial obligations -- before services are provided.
- Policies from The Memorial Hospital (TMH)
TMH is a critical access hospital and does not have the resources to estimate in advance every patient’s expected financial obligation. Still, management has developed clear policies and procedures to respond to patient requests by providing written estimates of expected charges.
Click here for 5 steps towards achieving pre-service (or point-of-service) agreement on payment expectations between providers and patients.
Click here to read about Advance Estimates: 4 Approaches to Price Transparency in Health Care, HFM, August 2006.