Tips for paying less for your next medical test

You can save thousands by medical shopping

CLEVELAND - From shopping for a car, to buying food, prices are posted and prevalent. But, price is the last thing you see or talk about at the doctor's office.

"When they hand you the piece of paper, 'here go to this facility for this,' you just go and do it," patient Jeff Sindelar said.

Sindelar's CT scan cost him thousands of dollars instead of hundreds because he didn't shop around for price and he didn't ask for discounts.

"You just assume it's all competitive," Sindelar said.

Shop around
Sindelar could have avoided the costly mistake if he spent five minutes on the phone and five minutes online.

Hospitals are required by state law to post the prices for common procedures on their website from visits to the ER to the operating room. Plus, they post prices for radiology and lab work.

"Didn't know a thing about it," Sindelar replied.

Getting the information from hospital websites is easy. It's difficult, though, to get the information from independent medical facilities.

5 On Your Side made these calls so getting this information might be easier for you.

We were asked lots of questions, and sometimes we still didn't get the numbers we needed.

Bill Ryan is the leading advocate for Northeast Ohio hospitals as President and Chief Executive Officer of The Center for Health Affairs .

He says you need to ask for the person in charge to get the answers you need.

"When you connect to someone who talks like that you need to say, 'who manages business functions of the office?'" Ryan explained.

Ryan says some insurance contracts make price a "trade secret." That's why some independent companies are reluctant to share the information.

Ryan eventually believes price is the future of medicine, and it will be used as a marketing tool.

Prices vary
"Today, with HSA (health savings accounts) and larger out of pocket amounts we have to start talking about price and negotiating price like we do any other major purchase," Ryan said.

In our medical test comparison, we found prices vary significantly at medical facilities around Northeast Ohio.

Here's a breakdown of the prices variations we found based on the numbers that were available on hospital websites, and the numbers provided to us by independent facilities:

CT scan - $1717
Ankle X-ray - $529
Thyroid Stimulating Hormone Test - $205.

While these numbers give consumers a reason to shop, Ryan says the price swings are not that extreme. The public hospital prices we saw posted on websites are what the industry calls a "charge."

"Charges are comparable to the list price of a car. It's the max amount you can pay, and virtually no one whether they are insured or not insured actually ends up paying those charge numbers," Ryan explained.

Insurance companies cut deals with hospitals, so the actual costs for care are lower than the prices the consumers see on a hospital website.

So, I asked Ryan why the state has a law that's irrelevant to the consumer's bottom line?

"It was irrelevant when they passed it. People were searching for data and they got data they just didn't get any information," Ryan explained.  "There are a lot of numbers there. It doesn't tell anyone anything. A lot of times what happens when people are in a hurry to pass laws they saw well we have this so we might as well throw it out there.  It really doesn't tell anyone anything about the actual cost of care and what you'll end up paying for that care at the end of the day."

Call your insurance company
Ryan says the listed prices are a good starting point, but he suggests you call your insurance company instead of looking online. That will get you the true price or the negotiated rate. 

Ask if there is a preferred provider.  Then compare that rate with the negotiated rate if its different for your doctor or hospital, and the rate for a  nearby independent medical facility.

Ask for a cash discount
Secondly, ask for a cash discount. We found they're common at independent imaging centers.

"It certainly is more beneficial to the provider if you are paying cash.  They don't have to wait for their money. There's less paperwork involved. They're in many instances willing to negotiate price and discount for cash," Ryan explained.

Sindelar learned that after he got hit with a bill he wasn't expecting.

"Even if I paid this imaging company out of my pocket it would have been substantially cheaper," Sindelar explained.

Your test won't count toward your deductible, but it might be worth it to pay cash if you have a high deductible plan and don't plan on meeting that deductible during the year.

Sindelar would have saved $1338 if he had gone to an independent imaging center instead of the one associated with his doctor, and paid cash rather than submitting the claim to his insurance company.

Every

facility has a different cash policy. Some require cash, credit, and debit only and won't take your HSA account money. However, you can always reimburse yourself later for those charges through your HSA account.

Ask about financial assistance programs
Most hospitals have financial assistance programs that can help make medical care more affordable if you meet financial guidelines. There are also sliding scales available to patients.

Some programs are only for uninsured families who are below 400-percent of the federal poverty level. While others hospitals consider financial assistance for patients with insurance if they meet financial guidelines.

In 2009, University Hospitals dedicated more than $234 million in community benefit related programs. In 2009, Cleveland Clinic donated more than $497 million in community benefit.

Click here to learn more about the UH program: http://bit.ly/evGoun
Click here to learn more about the Cleveland Clinic program: http://bit.ly/f7NndH

Expect big changes
While shopping around will save you money, right now you have to call around and do a little math to figure out which method of payment is better for you. In a few years, Ryan expects it will be much easier.

"I honestly think we'll get to a place in 2-3 years where it becomes much more apparent what an actual healthcare procedure will cost. I think federal law will chip away at the insurance companies ability to hold these prices in secret," Ryan explained.

Experts say consider more than just price
Price is just one thing to consider -- experts say also look at the quality of care, expertise, and infection rates. Always consult your doctor before you make a medical decision.

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