SUBJECT: Disclosure of Estimated Health Care Costs

 EFFECTIVE DATE:  July 26, 2009

Policy

Effective July 26, 2009, Washington State law requires that all fees and charges for health care services by health care providers and licensed facilities must be disclosed at the request of the patient.  Providers and facilities may refer a patient to the patient’s insurer for specific information on the insurer’s charges and fees, any cost-sharing responsibilities required of the patient, and the network status of ancillary providers who may or may not share the same network as the provider or facility.   South Sound Radiologists have posted a notice in the patient registration area and on the company web site indicating that patients may ask about the estimated charges of their health care services as provided by this facility. This policy will comply with all applicable requirements.

Procedures

I. Estimate of Fees and Charges

1. Health care providers licensed under Title 18 Revised Code of Washington (RCW) and health care facilities licensed under Title 70 RCW shall provide the following to a patient upon request:

a.      An estimate of fees and charges related to a specific service, visit, or stay; and

b.     Information regarding other types of fees or charges a patient may receive in conjunction with their visit to the provider or facility. 

2.  This facility, after disclosing estimated charges and fees to the patient, may refer the patient to the patient’s insurer, if applicable, for specific information of the insurer’s charges and fees, any cost-sharing responsibilities required of the patient, and the network status of ancillary providers who may or may not share the same network status as the provider or facility.

3. This facility has posted a sign in the patient registration area containing the following language: “Information about the estimated charges of your health care services as provided by this facility is available upon request.  Please do not hesitate to ask for information.”

4.  In order to estimate charges, the correct Current Procedure Terminology Code(s) (CPT) must be provided to South Sound Radiology via a valid provider order for services.  After receiving a written estimate of health care costs by South Sound Radiologists, patients must then contact their insurance carriers to determine eligibility, coverage level, etc.  Patients should be aware that information from both the insurance carrier and South Sound Radiology is date sensitive.

References:

Revised Code of Washington (RCW) 70.01 and 70.41 (http://www.leg.wa.gov/legislature)

Substitute House Bill 1869: Bill Report (http://www.leg.wa.gov/legislature)