1. What is My Cost?
My Cost is an online tool that allows patients to obtain an estimate of actual costs they will incur for a specific medical test or procedure, along with their out-of-pocket responsibility. Currently, the estimate includes facility fees for all services and now offers professional fees for any radiology service (example, MRI, CT, diagnostic, x-ray, mammography).
2. What information is available through My Cost?
Consumers will find out-of-pocket cost information that is specific to their insurance plan design. For example, if a patient with coverage through United Healthcare accesses the site and selects a procedure, the estimated out-of-pocket cost based on the negotiated contract with Alegent Creighton Health will be applied.
3. Which insurance providers are included in My Cost?
My Cost is an ongoing project initiated in January, 2007. Currently, 75% of insured consumers are able to access cost information through My Cost. Alegent Creighton Health is continually working with to add additional payors to make My Cost as accessible as possible. Consumers who are insured through Aetna, Blue Cross Blue Shield, CIGNA, Coventry Healthcare of Nebraska, Medicare Parts A and B, and United Healthcare are able to receive relevant, personalized cost information, based on their health insurance plan. Self-pay information is also available.
4. How can I get an estimate if my insurance is not listed on My Cost?
Please either contact 1-888-7MyCost (1-888-769-2678) or email your inquiry to MyCost@alegent.org for assistance.
5. What services or procedures will be listed on the My Cost site?
The most frequently utilized hospital inpatient and outpatient procedures, hospital diagnostics (CT, Lab, MRI, mammography, radiology, x-ray), therapy services, select physician clinic procedures, pharmacy, cosmetic procedures and Quick Care services. Medicare self-administered drugs are not included on My Cost.
If you are unable to locate your desired service/procedure, please either contact 1-888-7MyCost (1-888-769-2678) or email your inquiry to MyCost@alegent.org for assistance.
6. How were services selected for My Cost?
Services were selected using three criteria: volume, consumer requests, and national data.
Alegent Creighton Health looked internally for procedures and services that were high volume in each of the major categories. Consumer activity was tracked through calls made to the Alegent Creighton Health Business Office requesting cost information. Alegent Creighton also looked to their employee health plan partner in consumer directed healthcare for national information about those services consumers were cost shopping.
7. What makes up the cost of the service or procedure?
Currently, the out-of-pocket consumer cost includes both facility and professional fees for any radiology service listed on My Cost. (Radiology services include diagnostic, mammography, MRI, CT, or x-ray).
Quick Care costs represent the cost to the consumer when visiting any of Alegent Creighton Health's Quick Care clinic locations.
All other services listed on My Cost represent the facility fee only; in other words, these services are those billed by the hospital providing the service; the physician (or professional) fee would be billed separately.
8. What is the difference between a facility fee and physician fee?
The facility fee charges contain the costs of services related to the room, supplies, nursing services, housekeeping, etc. For example, the facility fee for an x-ray contains the costs related to the facility; x-ray machine, x-ray technician, film, support staff, etc. The physician fee relates to the physician reviewing and interpreting the results of the x-ray. Typically, patients will receive separate bills from the facility and physician services at a hospital inpatient or outpatient setting.
9. What information is included to determine the out-of-pocket cost?
An out-of-pocket cost is the cost the consumer will pay as a self-pay patient or for a service after insurance payments are made. My Cost has the ability to calculate the after insurance balance by applying 1) remaining deductible; 2) co-insurance percentage; 3) stop-loss remaining balance; and 4) co-pays as applicable. For some insurance plans, this information will need to be entered in the calculation screen manually by the user in order to determine the out-of-pocket costs.
10. What is a deductible?
A deductible is an amount established by your insurance plan the consumer must pay before insurance benefits are applied.
11. What is co-insurance?
Co-insurance is a percentage of the allowed cost either the insurance or consumer will pay. For example an 80/20 plan typically represents that the insurance will pay 80% of the allowed cost and the consumer is responsible for the remaining 20% of the allowed cost, after the consumer's deductible has been paid.
12. What is a stop-loss?
A stop-loss is the maximum amount a consumer is typically responsible for in a calendar year for either individual or family coverage, based on his/her co-insurance percentage. For example, a stop-loss of $2,500 per calendar year reached by applying the consumer percentage to each service received until the $2, 500 is paid by the consumer.
13. What is a co-pay?
Typically, the co-pay is a set amount the consumer will pay to see a physician. For example, an office visit to your physician might have a co-pay of $20.00; the co-pay amount will be clearly identified in your health plan design.
14. Why are some of the fields in the calculation screen filled in after I selected a procedure?
As a convenience to consumers of some of the plans listed on My Cost, we are able to obtain that information electronically from your insurance plan and as a result, the information is entered for you in the calculation screen. Any fields that are blank will need to be completed by the consumer prior to receiving an out-of-pocket responsibility.
15. Are costs guaranteed?
With all the complexities involved in treating patients today, My Cost will provide the most accurate out-of-pocket cost estimate available based on what can be expected for a routine procedure or service. Disclaimer language is provided on the final calculation screen to alert consumers to the fact that the estimate is not guaranteed and does not, in all cases, include professional fees and extra charges that may be incurred if complexities are encountered during the procedure.
16. What statements will I receive?
You can expect to receive a statement from both your physician and the hospital providing the service if you had an outpatient or inpatient procedure/service.
17. Who can I contact to discuss my statement?
For hospital services please call either 1/888-296-9762 or 1/402-717-7878. For clinic services please call either 1/800-241-8173 or 1/402-717-4380.
18. What should I do if I receive an error message after entering my health plan information in My Cost?
If you receive an error message after entering in the health plan information, please either contact 1-888-7MyCost (1-888-769-2678) or email your inquiry to MyCost@alegent.org for assistance.
19. Why is Alegent Creighton Health taking this aggressive step in transparency?
Consumer expectations continue to rise for information on both cost and quality. As leaders in the healthcare industry, Alegent Creighton Health feels strongly about moving toward a more meaningful and transparent system for reporting both cost and quality. Alegent Creighton Health hopes that by linking quality scores with personally relevant, meaningful and actionable cost data, patients with have the information they need to understand the value of their healthcare and to make more informed healthcare choices - which will ultimately lead to better health outcomes.
20. What are others in the healthcare industry doing in this area?
To date, some health systems have begun to provide consumers "list price" or average cost information. Alegent Creighton Health's unique approach is even more customized for the consumer because it provides cost estimates based on an individual's health plan or personal financial situation, to help them more precisely determine the cost of the procedure(s) or test(s).
21. How can I ask questions or provide feedback?
Your questions and feedback are welcome and encouraged. Simply complete our online form, or call 1-888-7MyCost (1-888-769-2678).