| If you don't know what's going to be done during the appointment, they probably can't tell you what it's going to cost. But if you are going in for a specific procedure, you should be able to get the cost. Call the doctor and get the procedure code. Then ask for the amount that is going to be billed and the tax id of the person or company that will be sending the bill to the insurance company. You may need to get multiple procedure codes and talk to multiple billing departments. For example, I recently wanted to find out how much an MRI would cost. There's a fee to perform the MRI and a separate fee for reading the images. These are performed by different people, and therefore billed by different people. Next, call or livechat your insurance company. Ask them to run a test claim. Give them procedure code(s), the amount billed, and the tax id of party sending the bill. The insurance company can then tell you what the allowed amount is, that is, how much the insurance company and the medical provider have agreed upon for the specific procedure. If you have a deductible that you haven't yet met (and the procedure isn't something covered or partially covered before the deductible, such as preventative care), the allowed amount is the amount you will be billed by the medical provider. Obviously, this is a cumbersome process. Running the test claim took about 10 minutes in my case. This is apparently not a process that the insurance company has optimized for. But by going through the process, you are sending a signal that price transparency is important. With MRIs, it turns out that at least one local company has recognized the value of price transparency: https://twitter.com/xn/status/311886680145666048
(They also happen to be about $400 cheaper than the amount my insurance company negotiated with a large hospital.) |