As a healthcare provider, are you able to defend your fee schedule to both patients and insurance carriers?
A 2009 settlement in a lawsuit filed by New York’s Attorney General against United Health Group has resulted in the formation of an independent nonprofit entity named FAIR HealthTM. FAIR Health was called upon to create a database that uses a fair and open methodology for collecting and analyzing medical charges nationwide.
The database is used by health insurers, healthcare providers, and patients alike in validating UCR (Usual Customary and Reasonable) charges.
In these tough economic times, we are seeing more patients challenging provider fees. In the past, it has been difficult for providers and their staff to defend their fees to patients other than to state that “our charges are in line with the fees of other similar providers in our geographic area”.
Now, we have a wonderful tool out there called the FAIR Health Consumer Cost Lookup where we can direct patients to validate provider fees for themselves. Patients are able to lookup both dental and medical costs by zip code, procedure, and other search criteria to determine the average charge and out of pocket costs for treatment. A number of topics are also covered to assist patients in better understanding how their insurance works on the Health Insurance 101 page.
In addition, providers may use this tool to verify their own fee schedules to be sure that they are in line with the average estimated charges for their fees in a given geographic area. As more and more patients become aware of this new tool and begin utilizing it, it would serve providers well to review their fees against the database.
HRS Medical Billing, Inc. regularly assists its clients in setting fees and collecting every dollar that is rightly owed. If we may be of assistance, please call 888-211-1118 today!