A federal government rule requiring hospitals to display their prices for “shoppable” medical services went into effect in January 2021. The rule, which doesn’t apply to outpatient settings like ours, aims to improve price competition by revealing how much procedures will cost. Ideally, the rule will help patients make informed decisions about their health care.
At Surgical Healing Arts Center, our goal has always been to provide you with personalized care that includes transparency every step of the way. Cost can be a hurdle that bariatric patients may need to overcome on their way to healthier lifestyles. Although we are not required to abide by the rule, we remain committed to sharing information about healthcare pricing so patients can make informed decisions.
We understand that bariatric surgery is expensive and sometimes not covered by health insurance. However, the outcome of these life-saving procedures is priceless. Benefits can include dramatic reductions in high blood pressure, type 2 diabetes, and sleep apnea. Also, bariatric surgery can result in a reduced risk of heart disease and a host of other potentially life-shortening conditions.
The Price Transparency Rule
The Centers for Medicare and Medicaid Services’ (CMS) price transparency rule requires package pricing for up to 300 “shoppable” medical services at hospitals. These services can be imaging and laboratory services, elective medical and surgical procedures, and outpatient clinic visits.
Under the rule for hospitals, services that can be scheduled by a patient in advance are “shoppable” medical services. They are typically non-urgent, allowing patients to price shop and schedule a service at a convenient time.
The belief is transparency will result in better quality care and lower costs. Also, the idea is that patients will know what their costs are before they get a bill, according to an article in Forbes.
What “Shoppable” Medical Services Mean to You
We have always believed patients need to have all the necessary information to make important decisions about their health and bariatric surgery. As a result, we hold informational seminars and offer counseling to anyone considering weight-loss surgery to change their lives. Pricing transparency is important to help you make important decisions.
Bariatric surgery is often the only way people with severe obesity can regain control of their weight and lead a healthier life. It is not a decision patients or doctors should take lightly.
Cost is just one of the factors to consider. Other factors include selecting a surgeon who gives you confidence in their ability and who will support your weight-loss journey. Also, it is important to find a surgeon who has experience performing the surgery you need. A Michigan study found that complications decreased as surgeons performed more surgeries. In addition, it is important to be comfortable talking to and asking questions of your doctor.
In addition to experience, your surgeon should be board-certified. We are members of the American Society for Metabolic and Bariatric Surgery. You can read testimonials from other patients on their experiences. We have support staff that includes dieticians, counselors, nurses, and physician assistants, all with experience in weight-loss surgery. Our education program prepares you before, during and after surgery to help ensure satisfactory results.
Consider All the Costs
Surgical Healing Arts Center prices our services competitively, while continuing to provide comprehensive and inclusive treatment plans for our patients.
While most insurance carriers offer some sort of weight loss surgery coverage, your individual policy details what is included and what is not. Some policies specifically exclude weight loss surgery. For this reason, you will want to check your policy to see if you have coverage. If you provide your insurance information when scheduling your first appointment, our office staff will check coverage, benefits, and insurance prior to your visit. Bariatric surgery is a covered benefit under Florida Medicaid, Medicare, and Medicare replacement plans.
If you choose to pay out of pocket, our fee includes anesthesia, hospital costs for the surgery and overnight stay, surgeon fees, a bariatric program fee that includes pre-op education and post-op support, and a year of follow-up visits. The self-pay fee does not include preoperative medical workups such as labs, chest X-rays and medical clearances. But even when insurance does not cover surgery, it will cover pre-surgical workup as those items are billed under non-surgical codes.
To help you make informed decisions, our health professionals are happy to address any questions or concerns you may have. Please give us a call at (239) 312-5802 to set up a consultation. You may also contact us by filling out this form.