Network Health Plan offers price transparency
Move will give patients estimated costs prior to procedures
08 / 26 / 2008
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Maria Nelson, Media Relations
Affinity Health System
(920) 720-1752
(920) 554-0686 (pager)
MENASHA, Wis.- With rising food and fuel costs, consumers are becoming more and more price conscious and are seeking out information about pricing before they buy. In health care, finding the price for a procedure isn’t always possible, but Network Health Plan has taken steps to meet consumers’ needs.
Network Health Plan has joined the Wisconsin Association of Health Plans transparency initiative. The initiative calls for all health plans to provide commercially insured members, on request, the estimated out-of-pocket cost for a specific service from a specific provider.
“Our goal is to help individuals become better equipped to make sound health care decisions,” says Sheila Jenkins, president of Network Health Plan. “Joining the association’s initiative supports our members’ need to know.”
As part of the initiative, members call our Customer Service department at 920-720-1300 or 1-800-826-0940 Monday, Wednesday, Thursday and Friday 8am – 5 p.m. and on Tuesday 8 am – 4:30 pm and provide the following information:
- the name of the provider,
- the facility where the service will be provided,
- the date of service,
- the provider’s estimate of charges for the service,
- the diagnosis code,
- the CPT code, Diagnosis code or Current Dental Terminology code to be billed by the provider.
A customer service representative will process the request and call the consumer with the estimated out-of-pocket cost.
The association’s initiative is a voluntary commitment to go beyond current regulatory requirements and to give consumers the cost information most relevant to them. Network Health Plan will begin providing estimated costs on Sept. 1, 2008.
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For the Editor:
Affinity Health System, a faith-based regional health care network, is the Fox Valley’s second-largest employer, according to the Fox Cities Chamber of Commerce & Industry. For the fourth consecutive year, Affinity has been named one of the nation’s top 64 health systems based on clinical performance according to Thomson Reuters, a leading provider of information and solutions to improve the cost and quality of health care. For ten consecutive years, Affinity Health System has been named to the SDI (formerly Verispan) Integrated Health Network Top 100, an annual assessment of the 100 most highly integrated health care networks in the nation. Both St. Elizabeth Hospital in Appleton and Mercy Medical Center in Oshkosh rank among the top 1 percent of hospitals nationwide in terms of quality and efficiency, as determined by the 2007 Premier | CareScience Select practice National Quality Award. Members of Affinity include Mercy Medical Center and Mercy Health Foundation, Oshkosh; St. Elizabeth Hospital and the St. Elizabeth Hospital Foundation, Appleton; Affinity Medical Group, a regional network of 25 family practice and specialty clinics – 22 of which are recognized as NCQA Level III medical homes, the highest level of recognition – in 14 communities; Calumet Medical Center, Chilton; and Affinity Occupational Health.