How much is that MRI anyway?

May 20 2014
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It wasn’t long ago that most people would cringe at the thought of asking about the cost of a health care procedure recommended by their doctor. Now with more of their own money at stake, patients are acting more like consumers.

For the do-it-yourselfers, there are resources like the one compiled by the Wall Street Journal. Some insurers, like Aetna, are providing tools that help get beyond some of the pricing complexities that are unique to health care. “Unlike a television or car, the cost of a given health care procedure can vary widely between health facilities or doctors and from one region to another,” Chris Riedl, who leads Aetna’s national accounts product strategy, explained.

“Members saved an average of $170 in out-of-pocket costs for 34 common procedures by using the payment estimator.”

Instead of asking patients to search through network directories or rely on their doctors, who rarely know price information, Aetna has developed the Member Payment Estimator. The tool came out in 2010 and provides real-time cost comparisons.

“In our experience, Aetna members saved an average of $170 in out-of-pocket costs for 34 common procedures by using the payment estimator,” Riedl said. Aetna’s estimates are derived from actual claims, so the estimate is based on the person’s actual benefit plan, current deductible, copayments, Aetna’s negotiated rates and data on out-of-network providers.

As an Aetna member herself, Riedl uses the cost estimator frequently. “I rely on that tool quite a bit for looking into services like allergy testing for my kids. I’ve become very dependent on it,” she said.