2 investigates: Shopping for out-of-pocket medical procedures

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ATLANTA - Many patients have experienced the sticker shock of paying out of pocket for a medical procedure, but a Channel 2 investigation found the prices can vary wildly.
 
Atlanta resident Henry Stanback needed a CT scan, and his doctor told him to go to a hospital. But Stanback saved a lot of money by going to an outpatient imaging center. He couldn't believe the difference in prices.
 
“It’s pretty substantial,” said Stanback. “From what I understand, they can run from upwards of $2,500 all the way down to, over here, $300. So, it's a pretty substantial difference.”
 
Shopping around can take up time.
 
Channel 2 Action News called 10 local hospitals (at least twice each) to ask for the price of a simple procedure: a non-contrast brain MRI.
 
Some hospitals, such as Grady Hospital, named a price on the spot: $3,148. At other hospitals, getting an answer was a challenge.
 
When the hospitals were called a second time, half of them offered a different price for the same procedure.
 
At Piedmont Healthcare, the list price went from $4,180.51 to $7,079.76.

A Piedmont representative said, “The second estimate provided to WSB-TV was incorrect."

For Piedmont’s full statement, click here.
 
One day, WellStar Health System said its list price for a non-contrast brain MRI was $969.10. Later in the day, WellStar offered a different quote: $12,879.71.

When confronted about it, a WellStar representative said, "An error had been made in providing you the second price."

WellStar also required personal information, including a date of birth, before it would give out a quote. For WellStar’s statement, click here.
 
Emory Healthcare also gave two different quotes. The first quote was $2,510. The second quote:  $2636.

Emory said, “Emory Healthcare is working to develop a list of flat rates for more standard out-patient services.”

For Emory’s full statement, click here.

The average price at hospitals for the brain MRI was more than $3,000, compared with a call to an outpatient center called OMI diagnostics: $475.
 
“Health care financing is very complicated,” said Glenn Pearson, the executive director of the Georgia Hospital Association.
 
He said hospitals are more expensive than outpatient clinics because they have high overhead. Hospitals do not turn patients away, and they operate 24 hours a day, seven days per week.
  
As for the difficulty getting a price, Pearson had a surprising suggestion: He said a hospital isn’t the best place to go to for financial information.
 
“The best place to get that information is to contact your insurance company,” said Pearson.

Pearson said hospitals recognize that with high deductibles, consumers are more interested than ever in getting upfront pricing, and he said hospitals are trying to become more responsive.
 
Smaller organizations are already doing that. Transparency is the industry's latest catchphrase.
 
“It's like going to buy a car,” said Dr. Richard Dukes, of Physician’s Express Care in Johns Creek.  “I don't want to purchase a car and then a month later, you send me a bill for this enormous amount of money that I had no clue about.”
 
Dukes teamed up with a new company in Georgia called HealthGate, where people can go online and shop around for health care. The website lets you lock in a price and prepay for treatment. 

A spokeswoman for the company said no hospitals have signed up with HealthGate yet, but Dukes remains convinced it’s the future of health care.

“The consumer is changing, business is changing, people are going to want better deals,” he said.
 
Patients who don’t want to shop around are asked to get the procedure’s CPT code from your doctor. That’s the precise code for the procedure and it’s the best way to get an accurate quote.



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