Make Ends Meet: How and when to shop around for healthcare

Updated: Jul. 22, 2020 at 10:15 PM EDT
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LOUISVILLE, Ky. (WAVE) - Medical bills can oftentimes leave people wondering why a procedure was so expensive or why they were not told what the cost of a serice would be beforehand. Oftentimes, the bills can cost as much as a person’s car. That’s why it’s important to know how to make ends meet when it comes to unexpected medical costs.

“I encourage consumers to shop their healthcare like they shop anything else,” stressed Jonathan Wiik, author of “Healthcare Revolution: The Patient is the New Payer” and “Healthcare Evolution: Helping Providers Get Paid in an Era of Uncertainty.”

Wiik currently serves as Principal of Healthcare Strategy at TransUnion Healthcare and has 25 years of healthcare experience in acute care, health IT, and insurance settings.

“Healthcare happens to people and with that, healthcare bills happen to people,” explained Wiik.

According to CNBC, 137 million Americans are struggling with medical debt and facing financial hardship because of medical costs. High health-care bills are the number one reason people consider taking money out of their retirement accounts or file for bankruptcy.

”Part of the reason healthcare costs are high is we use care pretty freely as consumers and we don’t educate ourselves as we go forward,” said Wikk.

The keyword is ‘consumers.’ A good consumer spends money wisely.

”When you go buy an automobile or you go buy a television or you shop for a vacation, you spend a significant amount of time understanding what the value is of what you’re getting,” shared Wiik. “Whether it has the features and things that you want and I would encourage you to be an empowered consumer to do that.”

This is not possible in the midst of an emergency but for an elective or planned procedure, planning and cost-cutting may be possible.

“Go to the hospital website,” exclaimed Wiik. “Do a search of providers in your area. Do your homework before you get the care and really look at those procedures. Understand your insurance and call your insurance company. Pull out that card. Get onto the website. Look at what your coverage, your network, what your out of pockets are, what your options are.”

Asking questions and making the right choices can ensure a person’s health and help them avoid being broke. For comparing the cost of medical care, these websites may be helpful:

  • - Hospital Compare is a free federal tool that compares hospitals by quality measures such as death rates for certain medical conditions, readmissions, and the overuse of imaging.
  • - offers hospital data created by the Commonwealth Fund, a health care foundation.
  • - offers links to groups and studies that provide price comparisons and quality ratings
  • - A free tool that allows consumers to find prices and discounts for thousands of prescription drugs at more than 70,000 local and mail-order pharmacies.

“Ask lots of questions when you’re at the doctor’s office or at the facility,” Wiik proclaims. “How much is this going to cost me? Where can I find out my cost? What payment options are there available to me? What financial assistance is there?”

Emergency room costs can be astronomical, even for items that can be purchased at a corner drugstore.

Also, it’s important to look up where the closest in-network-hospital is if possible to lower costs. However, even that does not ensure in-network doctors will be available. When doctors and hospitals join a given health insurance plan’s network, they agree to specific rates for their services, including everything from a routine physical to complex surgery. A doctor may be in-network, but the anesthesiologist or others around the table may not be.

Emergency rooms also have hidden costs like an ER facility fee, which is what ERs charge patients for walking in the door and seeking care even if a doctor isn’t seen. It’s like a cover charge if you walked into an expensive bar.

Ways to avoid this situation:

  • Talk to the billing department. There are several sets of costs for the same procedure at most hospitals
  • Ask for an itemized accounting
  • Ask for a payment plan
  • Discuss if the hospital has a financial aid program

Anyone unexpectedly admitted to the hospital with no time to prepare to pay the bill should reach for help by talking to someone at the hospital before being discharged.

”It’s much better to have those conversations as a consumer with a person instead of trying to talk to a statement or paper envelope that’s sitting on your kitchen counter at home,” explained Wiik.

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