Empire Blue (Anthem): https://www.empireblue.com/machine-readable-file/search/
United Healthcare: https://transparency-in-coverage.uhc.com/
Aetna (Seems like the right page, but I don't see any download links — possibly because they haven't been posted yet): https://health1.aetna.com/app/public/#/one/insurerCode=AETNA...
Search keywords: https://www.google.com/search?q=machine+readable+files+trans...
Do the insurers have any incentive to negotiate well? Since their customers are not very price-sensitive (since they aren't marketing directly to patients or doctors), I would imagine they don't have a huge incentive to do anything but apply a markup to whatever prices the hospital tells them it costs.
Here is an exchange I had with a major hospital about standard surgery (one of those deemed "Shoppable services") earlier this year. This exchange was possible after I was able to get an email recipient, following a 30min conversation.
I was told by the very helpful Ms. XXX, that you would be able to provide patient responsibility amount , related to CPT codes for XXX procedure. I am attaching front and back of my insurance card (Payor). The member DOB is MM/DD/YY
The specific 2 codes in question are : CPT 12345 CPT 01234
Can you please provide the total cost and patient resp. for the CPTs above?
>>>>>The hospital does not process estimates for patients with insurance coverage. However, our web portal contains charges under the Hospital Price Transparency link. I have included the link in the subject line for easy access. [comment: This link was broken. After much browsing.. I was able to find an alternate route. The linked file turned out to be a JSON. I couldn't figure that one out] As far as out-pocket responsibility, your insurance company is the best source for that information; they will advise if you have any copay for the encounter.
Read the 1st sentence of the reply again. My blood still boils from that...
Do you like 90% margins? Doctors sure do! :)
Being able to better understand prices before hand will drastically help people reduce their healthcare costs.
More opaque: costs more. More transparent: costs more.
Want a better deal? Choose better parents pleb.
Ah, but in the USA, there are a lot of uninsured people who end up paying cash for stuff. And there is a corruption problem in that individuals who pay for services and materials get ripped off compared to what insurance pays behalf of an insured patient.
I would expect that this will have an almost instant beneficial effect for some of the uninsured or under-insured. It will be harder to charge them $500 for something that insurance pays $250 for in plain view. People will go back and complain, asking for rebates even after paying.
I was in an ER for 7 days, I only saw the doctor 2 times for less than 5 mins each. In the final bill, the most expensive line item was doctor consultation.
If a person wants to pay directly in cash/credit-card for services rendered by a doctor, do doctors' agreements with insurance companies generally prevent them from offering a cash discount to cash-paying patiences lower than the insurance company negotiated price?
In the most recent case I tried to get a written quote for procedures because of past problems. I was given the run-around until all I could get was a verbal quote over the phone. But if that wasn't good enough, my only recourse was to delay getting a suspicious lump examined. I was then charged more than I was quoted, and I was even billed for procedures they didn't do. I actually heard one of the employees say "I added that because I thought he was using insurance". Still - hours of phone calls over several weeks before they would even bill me correctly without adding tests that they had no results from. And even then - more expensive than they told me because the person I was transferred to over the phone was in a different state than the clinic I called in the first place.
I expect much the same from health insurance companies.
That's not too bad, so I asked how much it would be to replace/update the lenses on my old frames, entirely at my charge.
It would've been $450. Just for the lenses.
I passed. I find it scandalous how much they can charge when just before they were perfectly happy to accept less than half that amount.
Instead I got another pair on EyeBuyDirect for $80.
It's not just the insurers themselves, but the whole system. Burn it all down.
That's the strange spam message I could never understand.
Surely doctors would be delighted at any method to improve health?
So I always assumed the "trick" to be quackery with dangerous side effects. After all, why else would "doctors hate it"?
Eventually I realised these messages are exclusively US American, the only place on the planet where doctors could plausibly resent people improving their health at the expense of their profits (or at least that's the implication that seems to rest on an entrenched cultural cynicism).
Am I totally wrong?