Medical Provider Newsletter - July 2020

To be perfectly clear

Medical cost transparency is a growing topic of conversation. And it’s no wonder—getting medical treatment and dealing with insurance can be stressful enough. No one wants an unpleasant financial surprise at the end.

We don’t have to tell you that full cost transparency in healthcare is complicated. It’s not like posting the price of a dozen eggs or a new iPhone. When it comes to medical costs, there are a lot of moving parts.

Of course, we shouldn’t let the fact that we haven’t got it all figured out yet stop us from doing what we can in the meantime.

One concern we hear from members is that they went in for a preventive exam, during which they mentioned allergies, for example, and they unexpectedly got charged a copayment—not realizing they had crossed over to a problem-focused exam. Or a member goes in for an exam—fully anticipating a copayment. In the course of the exam, the doctor spots a wart and offers to “take care of that” with a quick zap. Nothing to it. The pain comes when the bill arrives later that month.

We understand your services are valuable, and fee for service is the way most healthcare is delivered today. That is a discussion for another day. Today we are asking whether all parties could communicate better to avoid unpleasant surprises. After all, we don’t stick a patient without warning, “This is going to sting a little.”

EMI Health is committed to ongoing education of our members…explaining how billing typically works, suggesting they ask more questions, providing a Smart Cost Calculator, to name a few. We ask that you join us in that effort by proactively discussing potential costs with patients and verbally acknowledging when a service goes beyond the original visit or service scheduled, in addition to any general signage you may have posted.

Together we can provider our members, your patients with the information they need upfront for a more positive experience. We may not be able to remove the sting entirely, but we can help them understand what's coming and make better informed decisions.