A new website claims it can “eat your medical bills” like nothing else. Its name is “Billy” – yes, like in “billy goat,” the animal that can devour darn near anything.
Simply by taking a CPT or DRG code that identifies your medical procedure, you can find out what every provider near you charges for the same service.
“The site is great for anyone. But you’ll especially want to pay attention if you’re uninsured, on a high deductible health plan, or part of a health sharing plan,” said Marshall Allen, a medical cost watchdog ConsumerAffairs recently mentioned in our article about health costs.
“The easy price look-up tool can help you shop before you undergo care to make sure you get a fair price. It can also be useful after you’ve received care, to ensure you’re being billed fairly.”
Billy’s birth
Billy couldn’t have come at a better time. Things are so confusing for consumers when it comes to hospital services and costs, they’re often left hoping that hospital accountants are doing the right thing and treating them fairly.
“Most consumers believe they shop for care when they choose between health plan options during open enrollment. It then becomes a “grin and bear it” situation where many consumers feel trapped into their networks and the contracted rates their insurance carrier pays to the healthcare providers,” Cody Coonradt, Billy’s founder and CEO, told ConsumerAffairs.
“We believe this may be the biggest obstacle to change – lack of awareness that paying less for healthcare is possible.”
Coonradt says the second challenge is that people are unclear about what they are “buying” from the healthcare system.
“The general population tends to believe they are having a discrete event when they undergo a procedure. But the one event is split into a variety of bills, products, services, and billing providers, which is then re-grouped into an ‘episode,’” is how he explained the situation.
Before you know it, a consumer opens up a bill for, say, a hip replacement, only to be besieged by costs for procedures that the provider has bundled into the service.
Does Billy work as advertised?
When ConsumerAffairs took Billy for a test drive, it certainly widened our eyes to the fact that what healthcare providers are charging is all over the place.
First, we looked up the code for “X-ray exam of neck” (70360) to see what it would cost us if we lived in Phoenix, AZ. Prices ranged from $46 to $567.
For example, we could pay cash at the Verde Valley Medical Center and have the procedure done for $46 or we could opt for the insurance coverage which would run anywhere from $60 to $398.
Down the road, the Banner Thunderbird Medical Center was charging $411 cash and anywhere from $60-$411 for insurance-based prices.
A PSA exam (G0103) for a man who lives in Detroit could run anywhere from $15 to $114 according to Billy. For massage therapy (97124) in the Raleigh-Durham N.C., area, a patient would expect to pay anywhere from $33 to $124.
Motivated?
Coonradt told ConsumerAffairs that Billy aims to serve those who are motivated to check prices: the uninsured, health-sharing plan members and anyone with a high deductible health plan.
Consumers have other options, too. Allen said he likes the free Turquoise Health and fairhealthconsumer.org, which provide the average amount insurance companies are paying each locality.
“I also love healthcarebluebook.com, which gives you the estimated ‘fair price’ according to payments by self-funded plans. For lab tests, check out Jason Health,” he suggests.
And there will be more. The Hospital Price Transparency Rule is just gaining traction and there’ll be more startups that want to make healthcare costs affordable and accessible just as much as you want them.
