By Anthony Matt
In an effort to be more transparent about health care costs and help patients make informed decisions, Essentia Health is expanding pre-service estimates for all scheduled surgical services.
Essentia will provide an estimate of any deductible and out-of-pocket cost based on a patient’s insurance plan. The program started May 3 and is an expansion of Essentia’s adherence to the Patient Estimate Transparency initiative, which began providing radiology-service estimates in December.
Estimates come from historical services billed by Essentia. To ensure accuracy, providers will communicate specific scheduled procedures and surgeries ahead of time, and patients will receive price-estimate communications once their procedure has been scheduled.
The goal is for each estimate to be as accurate as possible, but in some instances there could be variability.
Informing patients upfront helps eliminate unexpected bills and allows Essentia to proactively communicate about options to make health care more affordable. The communication sent with patients’ estimates will inform them about interest-free payment plans, financial assistance, free Medicaid enrollment services and various real-time payment options — credit cards, cash or check, for example — if they are interested. Essentia’s financial counseling teams are available to assist patients with these options.
“Patients deserve to know prior to their service what their insurance plan will cover and what their insurance will leave as their responsibility,” said Melanie Wilson, vice president of revenue services at Essentia. “It offers peace of mind and ensures coverage is verified, costs are discussed, and payment arrangements are made in advance.”