Published Pricing Transparency & Compliance
Collects and publishes your chargemaster with ease to guarantee compliance and meet the Hospital Price Transparency Mandate
The Hospital Price Transparency Mandate seeks to make healthcare costs and negotiated insurance prices accessible to the public. Having a standard charge practice is difficult even if the chargemaster is current. Our answer to this new problem is Avelead PriceID, a tool that allows you to pull, change, and publish prices easily in compliance with the mandate.
Centralize Charge Information
The first step to compliance will be to identify your current charging practices. Avelead PriceID helps by going into the chargemaster and pulling all of the chargemaster data. PriceID easily makes current pricing information accessible, allowing you to standardize and publish quickly.
Set and Publish Competitive Prices
Compliance is only the first piece of the puzzle. It will be important to learn how to price competitively in the new world of price transparency. That’s where Avelead PriceID can help too. PriceID is able to pull other hospital’s pricing data, allowing you to compare and react favorably.
Frequently Asked Questions
What is the Hospital Price Transparency Mandate?
The Price Transparency Rules are a set of regulations centered around making healthcare costs affordable ahead of time. Hospitals have until January 1, 2021 to become compliant. The mandate’s requirements include everything from making a shoppable list of hospital services, to posting negotiated rates with insurances online.
What does price transparency mean for my hospital?
Healthcare organizations only have a few months to become compliant. Hospitals will have to pull their prices from the chargemaster, and then standardize their charges. In addition, they need to communicate with insurance partners so they can publish their rates, and if possible renegotiate. Finally, they need to find a way to publish all this information online in a user-friendly format.
When is the deadline?
The deadline for price transparency is January 1st, 2021. From the time the new rules were announced, they were challenged by a coalition of healthcare providers and insurers. However, their challenge fell short when it was struck down by a Federal Judge, and so now hospital are left with just a few months to become compliant.
What is the penalty for non-compliance?
There are two penalties, the obvious fine from the CMS, but also the penalty that the public will inflict for lack of pricing transparency. For hospitals that are not prepared, the penalty is a up to $300 each day for every noncompliant hospital within a system. That kind of penalty can add up quickly, especially within a larger system that has multiple noncompliant hospitals. The second penalty is more ominous. If hospitals are not prepared the public will choose the healthcare organizations that have published their prices.
How do I competitively price?
The mandate means that potential patients will be able to compare prices at will. That can be scary, but forward-thinking hospitals will see this as an opportunity. The first step for price transparency is publishing prices in line with the new rules. The second, and more important, step will be finding prices that allow your hospitals to compete. Healthcare organizations need to build competitive intelligence. What are other hospitals charging? What is their pricing strategy? Are they compliant? Answers to these questions will let you lead in the new world of price transparency.