Transparency

May 5, 2008

  1. somarco
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    somarco GA Medicare Expert

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    Transparency is a buzz word in the industry. Some carriers do a better job of getting this information out to agents & policyholders while others fall behind.

    Because I am doing a lot of business with Humana, I have found some of their resources but have not see the same with others.

    Humana has the following.

    Rx pricing

    From the above link you can get specific pricing by Rx name as well as access a table of generic comparisons

    Also, Humana gives you pricing by par provider for routine items. Go to their main site and login as a broker.

    Log into Humana.com
    Go to marketing & Products
    Go to Consumer tools at the bottom of the page
    Choose "my choice" tool

    Looking for other links on the Humana site I may have missed, as well as similar information from other carriers.
     
    somarco, May 5, 2008
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  2. NewHealthStrategies
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    NewHealthStrategies Super Genius

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    Aetna is the only one I've found that has TRUE transparency, in other words, you'll find the actual charges of the Doc's on the site.... but you have to have a log-in... which I have ....... somewhere...... I'll email it to you when I find it. Grrr.... now where the heck did I put THAT?
     
  3. somarco
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    somarco GA Medicare Expert

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    The Humana links (above) give you price ranges by doc, hospital or OP facility for specified procedures.

    I recall looking at Aetna's info last year. It was limited by geography. Only a few cities and zips had the info. For example, I was trying to find pricing for a client in Augusta only to discover there was no data (at that time) for Augusta.

    UHC also has some tools for policyholders but have not accessed them in a while.
     
    somarco, May 5, 2008
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  4. arnguy
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    arnguy Guru

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    Maybe if you stopped beating your head against the wall you will find it!:D
     
    arnguy, May 5, 2008
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  5. NewHealthStrategies
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    NewHealthStrategies Super Genius

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    Hah... found it, even with all the head-banging.

    Go to: Aetna.com and in the log-in use the following as YOUR USERNAME and YOUR PASSWORD:

    hmomed1

    Then...in the middle of the demo member page will be a link for COST OF CARE.... play around and see true transparency.
     
  6. NewHealthStrategies
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    NewHealthStrategies Super Genius

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    Here is a great example:

    ATLANTA, GA

    |VAGINAL DELIVERY UNCOMPLICATED PATIENT

    Northside Hospital (#1 baby hospital in the US) charges: $5,578

    Just up the road in North Atlanta is Northeast Georgia Medical Center.... which charges $9,110 as its' highest charge.

    Hmmmmmmmm...... if YOU were footing the bill (which you should for maternity, since you HAD 9 MONTH'S NOTICE TO SAVE FOR IT).... where would YOU go? The #1 baby hospital in the US or the local hospital?

    THESE ARE ACTUAL CHARGES NEGOTIATED BY AETNA... so they are at a discount to begin with!!!!
     
  7. indmedins
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    Thanks for the links. Very helpful.
     
  8. TXINSURANCE
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    I am waiting for underwriting transparency and blocking transparency. LOL.

    I Was really upset recently I had a VERY minor test conducted and NO ONE could tell me the price. (Endoscopy) Turns out it was $6000 or so, and my carrier negotiated rate was crummy at best (under 30%).

    There goes my HSA money I was building up. It would have been nice to compare the 6 other local hospitals. Ohhh but wait my insurance was not accepted at the other 5, and my doctor doesn't use the other 5 either. I would drop him in a heartbeat but the other doctors were 2 to 3 months to get an appointment.

    My insurance carrier only had 6 in network doctors in the 4th largest city in America - what a deal!

    I guess I was meant to be out of luck either way.

    I'll put them on the $5 a month repayment plan - they can take a number. Until illegals and others on free socialized medicine start paying - I am not paying either. I am going to go buy a new T.V. instead.
     
    Last edited: May 5, 2008
  9. wildcat
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    wildcat Super Genius

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    TX tell your Doc your insurance lapsed and you have no way of paying that amount ... watch the price come down.
     
    wildcat, May 7, 2008
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  10. somarco
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    somarco GA Medicare Expert

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    Subterfuge is totally unnecessary . . .
     
    somarco, May 7, 2008
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