Change Healthcare helps providers comply with CMS price transparency rule

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Change Healthcare helps providers comply with CMS price transparency rule

Press releases may be edited for formatting or style | January 12, 2021 Business Affairs Health IT
NASHVILLE, Tenn.--(BUSINESS WIRE)--Jan. 12, 2021-- Today, Change Healthcare (Nasdaq: CHNG) highlighted two options to help providers meet the new CMS price transparency requirements. The Transparency module for the company’s online healthcare eCommerce solution, Shop Book and Pay™, lets patients view pricing for shoppable healthcare services from multiple providers, helping make the process of shopping for healthcare as easy as online retail shopping. The Clearance Estimator Patient Direct solution provides financial estimates for a patient’s out-of-pocket cost for visits, tests, and procedures. Both options also allow patients to view the hospital’s complete pricing data for all services, presenting them with valuable comparison data and giving providers a single-vendor solution to help comply with all CMS transparency regulations.

The CMS Hospital Price Transparency Final Rule requires hospitals to publish a machine-readable file of their standard charges for all services. The deadline was Jan. 1, 2021. This data includes the gross charge, discounted cash price, payer-specific negotiated charges, and the de-identified minimum and maximum charges negotiated with all third-party payers, as well as relevant billing codes and the physical location of each service. Hospitals must also provide potential patients with an online price estimator tool or consumer-friendly searchable list for 70 CMS-specified shoppable services, plus 230 provider-chosen shoppable services. As noncompliant hospitals face daily fines of $300 per location, health systems nationwide are in urgent need of technology to help them meet both CMS requirements.

By creating a convenient digital storefront for potential patients, the Shop Book and Pay™ solution helps providers compete in the marketplace and differentiate their business in a crowded market. Patients can conduct a search for a specific procedure, selecting their insurance provider and plan to receive a list of available locations and full pricing information. With implementation of the Book and Pay modules, the patient can select an appointment time and complete pre-payment up front, before care is given. Clearance Estimator Patient Direct allows patients to search for common procedures and services via their provider’s website. Using historic procedure charge data coupled with real-time, patient-specific benefit data, the solution returns a personalized estimation of the patient’s out-of-pocket cost.

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