Consumer Health Blog

Understanding the Cost of Healthcare and the Availability of Self Pay Rates

Wednesday, April 25th, 2018

The cost of healthcare is an issue that is finding its way into the spotlight more and more. The questions
are now stretching beyond the affordability of insurance. The questions are now being asked “Why do we not
understand the true cost of healthcare?” When you go to the grocery store to buy a dozen eggs, the cost is straight forward. If you decide you want to upgrade and purchase cage free, organic eggs, the increase in cost is understood. So why is it when a patient receives an “Explanation of Benefits” when they receive medical services through their insurance, it’s not nearly as clear cut? Between deductibles, co-pays, co-insurances and the difference between what is charged, what is reimbursed and what the patient ultimately ends up owing…the confusion is understandable.

Patients are becoming wise as to why it pays to do their research when it comes to the cost of healthcare. The Philadelphia Inquirer is currently doing a series on the cost of healthcare. One patient sited that they forgot their insurance card and were surprised to learn after the fact that it would have been less expensive to pay cash for the service versus having it billed through her insurance. However, it is also important to understand that when you choose to pay cash for medical services when you have insurance, the amount you pay cannot be applied to your deductible. It’s a statistical equation everyone must weigh for themselves. Do you want to pay the lesser amount now and have those costs not be applied to your deductible? Or, alternatively, do you think you or your family may require more care, meet your deductible and ultimately decrease your healthcare costs?

The answer to this question is also affected by the type of care you anticipate requiring. Paying cash for standard services like well visits, sick visits that may require an antibiotic, basic lab work and diagnostic imaging may have a favorable cash pay rates. However, if you find yourself in specialty and sub specialty care (an example being diabetes leading to cardiac care amongst others) you may find that type of care largely tied to large hospital systems where readily available cash pay rates and accessibility to the best specialists are more difficult to find.

In an effort to help patients evaluate what their needs are, Abington Surgical Center is pleased to have a published cash pay rate for surgeries. This allows patients to do their research and choose the option that best suits their needs. This information is published and can be found by clicking on the “billing” tab above. Once connected to that page, you can scroll down and click on the button that will connect you to the self pay rates. In addition to procedure pricing, you will also find a pricing disclaimer stating what these rates do and do not include.

These rates are not only good for families to understand, but are also a benefit if your insurance is through a self-insured work place. As an independent accredited surgical center (ASC), not only does Abington Surgical Center deliver outstanding care with an excellent record of patient safety, but does so at a cost that is beneficial to both individuals and companies.

Do your research and know that we’re in this together!

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