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What To Expect From Pricing Transparency This Year

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What To Expect From Pricing Transparency This Year

February 23
23:28 2021
What To Expect From Pricing Transparency This Year

MC AnalyTXs expects the healthcare world to be disrupted significantly by the new pricing transparency rules that took effect on January 1, 2021.

These new pricing transparency rules, enacted as part of the Affordable Care Act, are requiring hospitals to provide public information regarding the “standard charges for items and services” that they offer to their patients and clients.

Hospitals and medical facilities are going to be required to transparent pricing information across five specific areas, including:

  • Gross Charges
  • Discounted Cash Rates
  • Payer Specific Negotiated Charges
  • De-Identified Minimum Negotiated Rates and
  • De-Identified Maximum Negotiated Rates

Two specific medical market participants are not beholden to these new rules (Ambulatory Surgery Centers and as well as positions that aren’t employed by hospitals directly), but everyone else will be making big changes to the way they share pricing with their patients and clients.

Disruption due to these major new rule changes is inevitable. MC AnalyTXs is predicting significant growing pains as hospitals work through finding the best ways to be in compliance with these new rules while maintaining pricing flexibility.

Thanks to their track record of helping hospitals recover millions in underpayments over the last 22 years, MC AnalyTXs is uniquely positioned to assist hospitals and medical clinics prepare for and implement these changes without significant disruption.

With the MC AnalyTXs AllPayor® Software system, medical organizations are going to be able to leverage a system designed to facilitate smarter contract modeling and claim management.

Using the AllPayor® Software system, hospitals will be able to adhere to all of the new pricing transparency rules and regulations while at the same time creating hospital specific claim, payment, and payor contracts that allow for a lot of flexibility as well.

Leveraging the entirety of your hospital’s claim data, payment data, and your negotiated contract terms with payors, AllPayor® Software is able to use that information in conjunction with the MCA ASP Oracle database to provide unique and specific price quotes on the spot.

This guarantees strict adherence to the new pricing transparency rules and regulations that went into effect at the beginning of the year without much extra effort.

Hospitals are able to produce transparent and detailed quotes (including information regarding usual and customary charges) inside of about 60 seconds – speeding up the furnishing of transparent pricing information without adding a lot of extra work or delay into the process, too.

MC AnalyTXs is currently making the AllPayor® Software system available to hospitals and clinics throughout the United States.

For more information about how MC AnalyTXs can help your hospital with pricing transparency rule adherence, contact them today at 281-920-0300 or join the upcoming webinar here for more details.

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