Healthcare // Patient Tools
12:44 PM
Core System Testing: How to Achieve Success
Oct 06, 2016
Property and Casualty Insurers have been investing in modernizing their core systems to provide fl ...Read More>>

Network Provides Healthcare Pricing Data

Transparent Health Network negotiates healthcare pricing with medical providers, and shares price data with its members online.

One of the factors driving up healthcare costs is lack of price transparency. When patients go to a healthcare provider, they don't know in advance how much they're going to spend, and they don't know how to tell whether a procedure is priced reasonably.

Transparent Health Network is looking to change that, starting in the New York metropolitan area, using Internet technology.

The service, which went online Nov. 1, is designed for uninsured and underinsured people. It negotiates pricing with healthcare providers just like an insurance company does, but unlike an insurance company, members of the service pay the provider directly. The service also includes a Web site where members can look up pricing in advance, so they can figure out what they can expect to pay before they go in for a procedure.

"One of the primary goals of Transparent Health Network is to create a better educated and better informed consumer and one of the most important parts of this is price transparency," said Andrew Rieger, VP of operations and technology for the company.

The Web-based service gives members access to a set of fee schedules for various procedures, organized in a way that's relatively accessible, Rieger said. Members can look up common procedures, like a checkup, pediatrician visit, or vaccination, and see the fees that individual doctors will charge for those activities. For example, a 30-minute preventative office visit is $104.37.

The fee schedule is also organized by specialist, with subcategories for typical procedures.

In a future version, the company plans to partner with a medical database company to connect established procedures with clinical events, and assemble packages of procedures, with pricing for typical conditions. "When you go to a doctor's office, you may think you know what's going to happen, but you don't know all of it. There's only so much a non-medical person can know," Rieger said.

For example, in the next version of the service, a member will be able to look up a broken arm, and find that it typically requires a level 3 visit, with X-ray and casting procedure, and get pricing for the entire package of services.

1 of 2
Comment  | 
Print  | 
More Insights
Newest First  |  Oldest First  |  Threaded View
Register for InformationWeek Newsletters
White Papers
Current Issue
Top IT Trends to Watch in Financial Services
IT pros at banks, investment houses, insurance companies, and other financial services organizations are focused on a range of issues, from peer-to-peer lending to cybersecurity to performance, agility, and compliance. It all matters.
Twitter Feed
InformationWeek Radio
Sponsored Live Streaming Video
Everything You've Been Told About Mobility Is Wrong
Attend this video symposium with Sean Wisdom, Global Director of Mobility Solutions, and learn about how you can harness powerful new products to mobilize your business potential.