By Trent Mattison, MHA
Division Vice President of Operations
Health care is virtually the only service where the consumer is in the dark as to what it will cost. And that cost is increasingly shifting to you, the patient.
Higher deductibles and copays are designed to make people pause before seeking care because you are now paying more directly for the service. However, how do you determine what the service costs? A consumer of any other service can shop online, in newspapers or at the store. Price is transparent and evident. Who would go to the mall and buy clothes without a price tag, only to get a bill weeks later?
Healthcare Pricing
There are inherent hurdles to making the price completely transparent in health care. For example, insurance companies set different prices for different physicians/providers and each insurance company sets a different price for each individual provider. So if your insurance changes, so does the price you pay for that same service. All the while, insurance contracts do not allow publishing of their rates to the general public. While confusing and intimidating, there are tools available to help.
Prices at Digestive Health Centers in Dallas, TX
At Digestive Health Centers (DHC), our average cost is about 45% less for Medicare patients than almost any other provider in the Dallas-Fort Worth area. Generally, if you have private insurance your cost is at this same level of discount. We are independent, Ambulatory Surgery Centers (ASC) which allow us to offer the lowest cost.
While the vast majority of ASCs in the Metroplex have chosen a hospital partner to garner higher prices and reimbursement, DHAT/DHC is committed to taking cost and complications out of the system. According to HCBB the range for a colonoscopy with a biopsy, for example, is between $1,642 to over $5,000. In line with that, guroo.com lists the average price of a colonoscopy at just under $3,000.
DHC is generally less than $2,000, generally the majority paid by your insurance company, just as HCBB notes, with our centers at or below the ‘fair price’ as a ‘value-certified provider’; this also takes HCBB’s quality, outcomes, and patient experience into account.
Demand to Know the Price
We encourage you to be empowered and demand to know the price prior to accepting a referral. Ask if the physician or facility is an independent provider or employed or incentivized by a hospital. Ask what the price is for the service you will be provided. If they can’t or won’t answer these questions, shop elsewhere!
Our hope is that you can be a true consumer of healthcare and engage your physician in a price discussion. You can find out where you are being referred, how much it will cost, and the alternatives.
We also welcome you to visit Stop Colon Cancer Now and More Than Heart Burn. Digestive Health Centers sponsor these advocacy groups to spread awareness on digestive health, price, quality, and patient experience. Please contact us with any questions as we are here to serve you!
Some online tools you may find useful are on your insurance company’s website or a sample of other sites such as www.guru.comandHealthcarebluebook.com(HCBB).