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Form a pricing list

Patient Access Weekly Advisor, April 30, 2008

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In an age of competitive healthcare in which patients shop more than they ever have, some access managers may have already addressed cost estimates; now, with the new ABN, they all have to address it.

But what if the price for a service is not on an access representative’s “cheat sheet”?

Ideally, facilities should have an automated process to help determine coverage details and pricing, says T.T. “Mitch” Mitchell of T.T. Mitchell Consulting, Inc., in Syracuse, NY. If it’s not automated, a list of the top 20 tests that may not be covered and their prices would be sufficient—“maybe even only the top 10, since most physicians seem to get into a pattern of requesting the same lab tests over and over,” he says. “

This is way more significant than scripting,” Mitchell adds, “because access staff should have already had somewhat of a script in place for when they had to give an ABN to a patient.”

In a pricing list, each item would be at a flat fee, but if a hospital has a discount rate for self-pay patients, it could apply that at the time. “With a list, there’s no big retraining or much change of a script,” says Mitchell.

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