Pricing Transparency co sb65 Info
As of January 1, 2018, Colorado senate bill 17-065 requires us to post on our website the prices for the 15 most common services we provide. These prices are for UNINSURED patients that would be paying cash. Patients with insurance should contact their insurance company themselves to obtain pricing information.
Unfortunately, the bill falls short of providing true transparency, making it difficult to compare apples to apples when shopping around for healthcare, especially for the majority of people that actually have insurance. To make it easier for our patients to understand, we have put together a list of frequently asked questions for both insured and uninsured patients so you have a better understanding of the complicated world of healthcare costs. You should consider these questions when your primary doctor refers you to an orthopedic specialist
FAQ’s:
Q: Do you charge a facility fee on top of these prices?
A: No, we do not. Academic entities and other hospitals will usually charge additional “facility fees” on top of any service/doctor’s visit.
Q: Are your surgical assistants and/or physician assistants in-network?
A: Yes. We do not do out of network billing.
Q: If I pay cash for surgery, is there a “global period” during which I don’t pay anything else?
A: Yes. For any major surgery, there is a 90 global period during which there is no additional charge for uncomplicated follow-up care with your surgeon. You will still however be charged for any additional xrays, unrelated evaluations and additional procedures if performed during those 90 days.
Q: Do you charge a facility fee during the global period?
A: No, however Academic entities and other hospitals may charge you facility fees even during your global period.
Q: Do you operate at in-network facilities?
A: Yes. But with so many insurance plans, it is impossible to be in network with every single one. You can check with your insurance company before scheduling surgery.
Q: Do you perform surgeries at the hospital or outpatient surgery center?
A: Performing surgery at a hospital operating room is substantially more expensive. If you choose a doctor that is hospital employed, you are almost certainly going to end up having surgery at a more expensive hospital operating room. As an independent private practice, we perform all eligible surgeries at outpatient surgery centers. Generally, you will need surgery at a hospital if you are not healthy enough for an outpatient surgery center, or if your procedure requires post-operative admission such as most joint replacements.
Q: If your listed self-pay prices are cheaper than my insurance’s contracted prices with you, can I pay the lower price?
A: No. We are contractually obligated to collect the contracted rate, as you are to pay it. The discounted self-pay rates are offered at a fraction above our cost to provide these services recognizing the financial hardship of uninsured patients.
Q: Are your self-pay prices already discounted or are they a reflection of “billed charges.”
A: These prices reflect the discounted rate most commonly collected from UNINSURED patients and are not to be confused with “billed charges” you may see on an invoice or EOB “explanation of benefits”.