The norm was that when
one was sick- they saw a doctor, received treatment and paid the bill. Not so
now. The bill can be negotiated, though not many are aware of this. Dr. Andrew Agwunobi, director of hospital performance
improvement at Berkeley Research Group in Washington, D.C. negotiated the
amount on his bill.
He saw a
dermatologist who could not diagnose the problem; still Agwunobi received a big
bill. "I called up the office and said that I felt like the bill greatly
exceeded the value of the office visit because I didn't get a diagnosis and I
didn't get any medication. And then that doctor's office actually cut the bill
in half," he said.
hospital administrator, Agwunobi also has been involved in price negotiations
with patients who can't afford their bills. "Many patients don't realize that
they can negotiate not just with doctors, but you can negotiate with your
hospital," he said.
"Patients are not empowered health-care consumers. It's very, very difficult
for patients to challenge doctors," said Vicki Rackner, a surgeon and expert in
the doctor-patient relations. "There's just a way that doctors and patients
interact. It's really hard to change that behavior."
United Health care, one of the nation's largest insurers, has a product that
allows clients to learn and compare prices of different providers through its
website or a mobile application before walking into a doctor's office.
Tori Bogatyrenko, an executive overseeing the company's price transparency
efforts, said that the prices were estimates based on current contracts.
"We're not just giving you a price for your office visit with the doctor but
will include what you pay the lab and what you might have with a radiologist or
other preventive screenings that are all part of what you experience in that
one visit but, in fact, you are paying a different bunch of people,"
Health Care Service Corp., which operates Blue Cross and Blue Shield plans in
Illinois, has developed the Benefits Value Advisor program. The system compares
cost estimates from in-network providers and facilities and also provides
patients' reviews on quality. Company executives say they analyzed data from
approximately 2,000 members in Illinois and Texas, those who chose different
doctors from the program saved almost $2000 per claim.
In New Jersey, a 5 year old website named Vitals.com allows people to search,
read and write reviews about 830,000 doctors nationwide. The website draws
approximately 100 million patients every year.
patients to get price information from doctors is very tough, many calls
messages and emails result in a very varied pricing.
feels the reason is also that doctors don't know the cost of drugs. "I was just
prescribing an antibiotic for a patient who had a really bad side effect
profile. I just had a drug rep come to my office and he told me about this new
antibiotic that avoided it, but it was 10 times as expensive. I had no idea,"
was glad that insurance companies were giving price estimates because they knew
best about health care.
"It will take some work, but hospitals can do better, and simply submitting
historical averages of what they have charged," Agwunobi said.
should come together to figure out how to quote prices, actual prices and hold
themselves to it, either prices or a price range," Agwunobi said. Providers
should stick to their range even in the case of complications, he added.
doctors and experts feel there is a marked transparency in the pricing, it will
be some time before patients can actually do comparative cost analysis.
Hannah Punitha (IRDA
Licence Number: 2710062)
Zongwei Li, March 2013