How to Shop for Healthcare
To shop for the best quality of care at the lowest price:
Search on your local hospital’s website for “price transparency. Look for both the discounted cash (self-pay) price and your insurer’s negotiated rate. The cash price is on average 39% less expensive!
For planned surgeries and procedures, look up prices at price transparent surgical centers like the facilities below, and use them to negotiate with your local hospital:
Check out resources like Turquoise Health, FireLight Health, and My Medical Shopper to compare prices across hospitals.
If you cannot find prices online:
Call your local hospital and “DEMAND” them. According to a federal rule, starting on January 1, 2021, hospitals are required to show you their prices.
Report the hospital to the Centers for Medicare & Medicaid Services (CMS) on the CMS website.
Write to the Management Team and Board of Directors of the hospital to let them know they are not complying with the federal rule that makes it your right to easily access prices online.
To watch the entire “How to Shop for Healthcare” series, click here .
Consult the new book Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win by Marshall Allen available here.
EVERY MEDICAL BILL IS DISPUTABLE. LEARN HOW YOU CAN PREVENT AND FIGHT OUTRAGEOUS MEDICAL BILLS BY FOLLOWING OUR TIPS BELOW:
1. Prior to your visit, research your insurer’s coverage and billing codes:
Call your insurer to ask which tests and services are covered, along with their associated billing codes. You can also get preauthorization from your insurance company to ensure coverage.
2. Shop around for medical tests and procedures and find a fair market price:
Look up what Medicare and commercial insurance companies pay for the service that you need. Healthcare price checking platforms such as Healthcare Bluebook and Clear Health Costs are also available to help patients’ find the best price.
For surgical procedures, you can also look up the price with other transparent surgical centers such as The Surgery Center of Oklahoma and Texas Free Market Surgery. You can then use those prices to negotiate.
3. Ask for the cash price:
Before your visit or procedure, offer to pay in cash. In many cases they will offer significant discounted rates for upfront, cash payments.
4. Refuse to sign any paperwork:
The Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospital emergency rooms to treat anyone needing emergent care and ensures public access to emergency services regardless of a patient’s ability to pay. If a hospital insists that you sign a form for financial paperwork, refuse by citing the EMTALA law, or sign it “DID NOT READ” instead of your signature.
5. Ask the physician or hospital to only use labs and providers that are in-network:
Make it very clear to your doctor that you want to stay in-network to avoid out-of-network charges. You can also call your insurance company to help you find nearby in-network labs and facilities.
For additional resources, visit:
Every day, innovative employers and providers are saving thousands for patients and businesses by implementing a price transparent healthcare model.
Americans can’t be expected to pay for healthcare with a blank check. Pulling back the curtains on healthcare prices will end surprise billing.