Berlin, Md. – As health plan deductibles rise and the portion of the hospital bill patients
are responsible for only continues to increase, the value of price transparency
to individuals considering their healthcare options is also rising.
Gone are the days when most insured individuals could expect to pay –
and therefore plan for – a flat co-pay for a lab test or an ER visit.
Preparing financially for an elective procedure, such as a hip replacement
or gall bladder surgery, can be even more difficult.
That’s a key reason Atlantic General Hospital and Health System has
launched a price estimator tool for its patients. The calculation takes
into account the average cost for the test or procedure in question, the
individual’s co-pay and co-insurance responsibilities under his
or her health plan and how much of the deductible has already been met.
This service is offered to patients when they schedule a procedure or diagnostic
testing or when they check in for their care. Estimate requests can also
be made online or via phone by individuals who are considering Atlantic
General Hospital and Health System for the care their doctor has recommended.
Patient Financial Services representatives are available 9 a.m. to 4 p.m.,
Monday through Friday, at 410-641-6448. Requests can be submitted online at
“We’re very excited about being able to offer this service
to our community,” said Pattie Stamm, director of patient financial
services at Atlantic General Hospital. “We feel being able to provide
these estimates helps build trust with our patients and allows them to
better plan financially for the care they need.”
Atlantic General has published estimated pricing for the most common blood
tests, imaging tests and surgeries on its website since 2011. While helpful,
these pricing charts don’t factor in patients’ individual
insurance coverage to help them determine what their actual out-of-pocket
cost will be.
Healthcare consumers can find themselves bouncing back and forth between
their insurance company and the healthcare provider to narrow down the
range of what they will owe. Atlantic General’s new service can
reduce the steps in the journey to that estimate.
Atlantic General has contracted with a third party, Experian Health, for
a secure electronic solution that queries patients’ current insurance
information and compares that information with the hospital’s fee
structure to arrive at an estimated out-of-pocket cost.
While the estimator tool eliminates a great deal of uncertainty related
to cost for patients, Stamm pointed out that it is still an estimate,
not a hard figure guaranteed to appear on the bill.
“The base cost for a service is an average, and it can fluctuate
somewhat based on the complexity of the patient’s condition being
treated,” Stamm said.
One example is the estimate for a routine colonoscopy. While the gastroenterologist
is performing the procedure, he may discover and remove suspicious tissue
for testing in one patient while another patient is free of such growths
and requires no further measures. The cost to the patient will be different.
But, the total will come as much less of a surprise.
Atlantic General Hospital and Health System is the first on the Eastern
Shore to provide this level of price transparency to patients and the
About Atlantic General Hospital
Atlantic General Hospital has been providing quality health care to the
residents of Worcester, Wicomico, Somerset (Md.) and Sussex (Del.) counties
since May 1993. Built by the commitment and generosity of a dedicated
community, the hospital’s state-of-the-art facility in Berlin, Md.,
combines old-fashioned personal attention with the latest in technology
and services. It provides quality specialty care such as weight loss surgery,
orthopedics, outpatient infusion for individuals with cancer or blood/autoimmune
disorders, retina surgery and a comprehensive women’s diagnostic
center. Atlantic General Health System, its network of more than 40 primary
care providers and specialists, care for residents and visitors throughout
the region. For more information about Atlantic General Hospital, visit