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VanderbiltHealth.com launches out-of-pocket cost estimator

Aug. 4, 2020, 8:15 AM

by Paul Govern

The Vanderbilt Health website now features an out-of-pocket cost estimator for many hospital and professional services offered by Vanderbilt University Medical Center. Anyone with an internet connection can use the new online tool to generate immediate estimates, with no website registration required.

“There is significant frustration among consumers about costs and the lack of price transparency in health care. Committed to help address this issue, we have been able to accomplish an important goal of placing information about many out-of-pocket costs at the fingertips of patients and their families,” said Cecelia Moore, MHA, CPA, Chief Financial Officer and Treasurer.

Vanderbilt Health patients can now get get online user-generated out-of-pocket cost estimates for selected services. (photo by Susan Urmy)

According to the leader for the cost estimator project, Heather Dunn, vice president for VUMC Revenue Cycle Services, few hospitals nationally are offering user-generated online out-of-pocket cost estimates, and no other Nashville hospital currently offers comparable technology.

“We want to be upfront with patients about what care is going to cost them out-of-pocket and provide a tool for patients to better understand their insurance benefits and what their potential costs might be. I think it will alleviate a lot of anxiety,” Dunn said.

“While we may be saying to a patient, ‘It’s going to be $1,400 for you to come here for your procedure,’ we can also say, ‘If you need help to understand the estimate, we can refer you to our financial counselors for assistance.’”

Patients can get online user-generated out-of-pocket cost estimates (hospital and professional services combined) for selected outpatient services, selected inpatient and outpatient surgical procedures and radiology services. Prospective patients can receive estimates for other VUMC services by calling Patient Financial Services at 615-936-6639.

Users enter the specific health services for which they want estimates. When insured users enter the member and group numbers from their insurance card, the estimator retrieves benefit information from the insurer via a secure internet connection; alternatively, these users can manually enter figures for their co-insurance obligation, remaining annual deductible and out-of-pocket maximum.

For My Health at Vanderbilt (MHAV) users, insurance card information is pre-loaded. These users can save estimates to their account and make electronic pre-payments.

Last year VUMC began sending patients automated out-of-pocket cost estimates for many scheduled services (via MHAV messages and automated telephone calls). According to the technical lead for the estimator, Jason Fromal, principal application analyst with VUMC Health IT, 87% of the automated estimates fall within 5% of the actual out-of-pocket cost, and this performance is expected to improve.

In the coming months user-generated online estimates will become available for physical and occupational therapy visits, selected outpatient services from Vanderbilt Women’s Health, and services from Vanderbilt Psychiatric Hospital. Online estimates for additional outpatient services will become available as it becomes workable to reliably marshal office visit co-pay information from insurers.

Online estimates for services at Vanderbilt Health’s newest hospital, Vanderbilt Wilson County Hospital, will be available following the completion of hospital IT systems integration.

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