UNC Health introducing cost estimator app for procedures

CHAPEL HILL

UNC Health wants to make it easier for patients to know how much their next hospital visit is going to cost.

The health system said Wednesday that it’s rolling out a new online feature that will give patients a real-time cost estimate for a variety of different procedures and visits.

The tool works for patients with or without insurance and incorporates a variety of costs that many patients don’t think about, such as facility and professional fees.

“We’re trying to get away from the feeling of people receiving surprise bills or things that they weren’t planning on,” said Kimberly Anderson, UNC Health’s executive director of pre-care financial services. “We want patients to know ahead of time what that expectation is.”

The cost of health care in the U.S. is notoriously opaque; patients have traditionally had no idea what a medical procedure or a visit to the doctor will cost ahead of time.

But in recent years there has been a push to give patients more upfront information on what a procedure might cost them. Earlier this year, the Centers for Medicare & Medicaid Services introduced new rules that required hospitals to post prices.

Anderson said that UNC Health has been working on its tool for a couple of years.

“What health systems and providers are being asked to do is growing,” she said over Zoom. “So we wanted to kind of try to get ahead of that and create a tool that patients could access on their own.”

The UNC tool runs a patient’s insurance through a real-time check, so that it can determine what they are eligible for and how much of their deductible has already been used.

The important part of the tool, she added, is that it is not just giving you what the cost of the procedure will be but an actual out-of-pocket cost estimate.

“We wanted to open up those doors of not just transparency about what our prices are … but really what your actual out-of-pocket cost is,” Anderson said. “Because those two things are very different from what we charge for services and what a patient will owe.”

Locally, Duke Health and WakeMed also have cost estimate forms that patients can fill out, but someone from the health systems must help calculate the estimate. UNC’s app allows a patient to run the estimate on their own.

At the moment, the cost estimator works for more than 50 services, including cardiology, orthopedics, rehabilitation, sleep studies and some office visits.

However, it is only available to patients at UNC Rex in Raleigh and UNC Medical Center in Chapel Hill.

UNC Health hopes that it will be able to expand it to other UNC hospitals and clinics in the state soon.

The health system is one of the largest providers of health services in North Carolina. The network includes 12 hospitals, stretching from Hendersonville in the mountains to Jacksonville on the coast.

“We’re currently working on the next phase which includes our other entities across the health care system under the UNC umbrella,” Anderson said.

This story was produced with financial support from a coalition of partners led by Innovate Raleigh as part of an independent journalism fellowship program. The N&O maintains full editorial control of the work. Learn more; go to bit.ly/newsinnovate