Pricing Healthcare is a completely open, independent, online marketplace for direct-pay healthcare.
Our aim is to bring visibility to healthcare prices and make paying for healthcare more simple and direct. We believe this will do more
to lower costs and improve the quality of U.S. healthcare than anything else.
A growing number of medical and dental facilities are listing their prices and marketing their services on our site. They're
simplifying payment models and streamlining their processes in order to better compete for patient customers willing to pay
up front (and who don't require the filing of insurance claims). At the same time, patients and employers are increasingly turning
to facilities that publish affordable, bundled, direct-pay rates.
Access to our site is free and open to anyone in the world wanting to view prices and other information posted by healthcare
facilities throughout the U.S.
Isn't direct-pay a lot more expensive
than going through insurance?
Surprisingly, no. A lot of media attention has been given to the high sticker prices obtained from
government and insurance data.
These charged amounts or list prices are typically not paid in full by anyone (insurance prices are almost always negotiated down from these
lofty rates). What most don't realize is that many facilities also have a history of offering uninsured and prompt-pay discounts
well below those rates, discounts that are greatest for those paying cash up front. It's these
discounted cash rates that you can find on our site. If you have insurance and can get a price quote from your insurer for all the services
that will be involved in your procedure, do a comparison yourself (it is much more helpful to do such comparisons before
getting a procedure, though usually far easier after you've received bills from all the vendors involved).
In the last 5-10 years, cash rates have fallen significantly to the point where some facilities are even willing to offer cash rates
lower than what they give patients with private or government insurance (Medicare and Medicaid). Direct-pay requires very little overhead,
which is a big expense and a growing burden for physicians. There is also no need for expensive patient billing and collections after the procedure.
Some facilities are leaving the insurance world altogether and are looking to ramp up their
clientele of direct-pay patients. For these and other reasons, direct-pay can be the cheapest way to pay for healthcare in many locations.
Is there a downside to using direct-pay?
In some cases. For insured patients, direct-pay medical care does not count towards a deductible.
Using direct-pay for covered services can therefore be an additional expense for patients who spend a lot more than their insurance plan deductible.
However, there are more and more stories being published of insured patients having to pay the full list price charged by a specialist, anesthetist, etc.,
because that physician was outside the patient's network, and the patient assumed at the time of care that insurance would cover the cost.
Is access to all data totally free?
Yes. All content on our site is free for guests and registered users alike. This includes our growing provider
directories and all price lists published by medical or dental providers.
What is the relationship
between Pricing Healthcare and the providers on the site?
All providers listing prices on our site are our clients, but we also think of them as partners.
Providers determine what services to list and what their prices should be, with Pricing Healthcare consulting providers to help them
be more competitive in the market.
The prices are honored by the facilities listing them. All pages are hosted on Pricing Healthcare servers with permission
from the providers, and all provider-related content on the pages is approved by the providers.
Who can benefit from this site?
Like any marketplace, our site benefits both buyers and sellers of healthcare. We help patients
find quality, affordable, direct-pay healthcare. We help providers by bringing awareness to their facilities and services,
and we are an important resource for employers and other organizations providing healthcare benefits for their members.
As cash rates come down to levels comparable with and in many cases lower than insured rates, it's not just the uninsured who
are interested in self-pay prices. More and more of the insured are interested in searching for and comparing healthcare providers on our site,
including patients with high deductible plans and those receiving care through employers. In fact, studies show a majority of patients in the U.S.
have a vested interest in finding more affordable care.
Pricing Healthcare helps consumers find providers of various specialties,
whether at home, away from home, moving to a new area, or wanting a change for a variety of reasons.
We're also working to help patients find information about quality of care and provider service quality.
I'm on Medicare – is there anything on this site for me?
80% of Medicare-approved charges are paid for by the government. The remaining 20% must be covered by the
patient or by supplemental insurance. Because there are regional and sometimes provider-level differences in Medicare rates, the amount of the
20% can be different. It would be unusual to pay less going direct than through Medicare.
However, some charges are not covered by Medicare, and more and more providers and facilities do not accept new
Medicare patients, making some high quality physicians and specialists out of reach. For all of these reasons, direct-pay options can be crucial
for those who qualify for Medicare. Nothing prevents a Medicare patient from going outside the government insurance program
to pay directly for care. Self-pay rates are the same at our facilities regardless of a patient's coverage status, but if a patient
uses self-pay rates, Medicare cannot cover any portion of the cost.
What types of healthcare providers are on the site?
We list prices for hospitals, outpatient surgery centers, imaging centers, and a growing list of other types of
healthcare facilities, providers, and specialties. We do not limit what types of facilities can list prices with us. As new providers begin
listing prices on our site, visitors will see more and more specialties listed.
Can my doctor's office use Pricing Healthcare when referring me to a specialist or hospital?
Yes. We encourage physician practices to know the pricing landscape for their patients. When you are referred elsewhere,
you should always ask about the expected cost regardless of whether your primary care physician bills you through insurance, or whether you
pay direct or via concierge. Our site is a great place to start, listing providers that are some of the highest quality in the nation.
If you are referred to a general hospital, ask whether the procedure could be performed at a specialty hospital, surgery center, or
imaging center. General hospitals are rarely the only option, but usually the most expensive. You should also ask
if a referral recommendation is due to an ownership stake in that facility, either by the doctor or the doctor's employer.
What's the process for adding healthcare facilities and providers in an area on this site?
We have a sales team that reaches out to providers all over the country. With over half a million facilities
and practices in the country, our priority is to contact those most likely to publish their rates. We encourage patients to let us know what
facilities and facility types they are most interested in seeing prices for. We also encourage patients to let their providers know how helpful
it would be to see their prices on our site. It is easier and faster for us to add facilities in an area when patients in the community
are expressing an interest to providers and to us. Press and media coverage, including social media, also help increase the rate of adoption
in an area.
What sort of things interest providers in listing prices with Pricing Healthcare?
Providers are primarily interested in increasing direct-pay patient traffic. Volume is typically greater through
employers, but most don't have a preference on whether patients come to them directly or through an employer. Other points of interest for a
provider are branding, name recognition, increased public visibility, and patient satisfaction.
There is no global directory today that lists providers of all specialties and types, along with their prices. In addition, many facilities
can't be found on search engines at all. Pricing Healthcare gives providers visibility for the services they provide with consumers of all kinds,
around the world.
What can I do to get my employer to participate?
Talk to the benefits manager at your organization. Most employers are still unaware of the huge savings available
by going direct with providers on Pricing Healthcare's site. Direct them to this site to see for themselves.
We work with employers to help them integrate direct-pay options into their existing health plans. They don't have to give up whatever
insurance network they currently use. Feel free to contact us and pass along you benefits administrator's
What advantages are there to registering on the site?
We are adding new facilities across the country every month, and we notify registered users when new pricing data is available.
Those who sign up also get access to all medical codes. An account is required to receive electronic statements through Pricing Healthcare
when direct-pay services are performed by providers on this site.
Patient advocates recommend the tracking of medical bills in some kind of electronic system. Pricing Healthcare makes this easy.
Is my subscription dependent on my current employer or insurance?
No. It may be temporarily linked to your employer's Pricing Healthcare account in order for you to access electronic
statements from a provider. But all electronic statements from providers stored in your account are available to you regardless of
changes to your employment or coverage. Nor will you have to learn a new pricing tool if you go to another state (either temporarily or permanently)
or if you change jobs or insurance carriers.
Do I need a Pricing Healthcare account for each member of my family?
A family or household paying medical bills under one name will typically need only one account.
Provider statements are tied to the specific patient under your account so you can track bills for multiple family members.
Is Pricing Healthcare independent or part of some other entity?
Pricing Healthcare is privately held, independent, and not controlled or subsidized by any provider,
health system, insurance carrier, or government entity.
Does Pricing Healthcare still get data from crowd-sourcing?
Pricing Healthcare began gathering data from a variety of sources, including data from
the crowd-sourcing of patient medical bills as well as from government sites. We now get data directly from providers,
data that is completely accurate and honored by the provider, without having to rely on the large volume of consumer submissions crowd-sourcing requires.
Can I use the site without submitting
data from my bills?
Yes. Our pricing data is now available without registration, free for anyone in the world.