How much will it cost? Consumerism among employees

January 19, 2006

There is a lot to consider when deciding on the type of medical care to choose. There may be a time when the cost of a test or procedure plays a role in the decision. Employees participating in Penn State Hershey Medical Center's health-care benefits plan have several options available to get an estimate of what something might cost.

The amount that is applied to a medical center employee's deductible (and HRA balance) is the Blue Cross Contracted Rate, not the full charge. While the cost of the test or procedure varies from case to case, Patient Financial Services will attempt to give employees the "most accurate estimate" possible.

For a broad estimate of some of the more commonly performed services, employees should access the patient financial services Infonet site online.

Select Blues allowed amounts for employees

For a more specific estimate, there are two options:

Call the Price Estimate Line at (717) 531-3805. Employees will be prompted to leave a voice message with information about their service. They will hear voice prompts asking seven specific questions. The call takes about two minutes to complete. In order to receive the most accurate information, an employee will be asked for the five-digit procedure code (CPT). This code can be obtained from the service ordering the test or procedure.

E-mail the Price Estimate mailbox in Groupwise ("PriceEstimate"). Employees should include the following information:

1. The fact that they have Penn State Hershey Medical Center benefits;

2. The CPT code and name of the procedure or test;

3. The location the procedure will be performed (Main Hospital, UPC, Nyes Road, Cherry Drive, etc.); and

4. Whether this is an inpatient or outpatient service.

Employees will receive a response within two business days.

The estimated amounts will include both the professional (physician) and technical (hospital) fees. Employees that have a question concerning something that may be covered as preventative or not a covered benefit at all are asked to contact the Capital Blue Cross Member Services department at the number located on the back of their ID card.

Medical benefit out-of-pocket expense

There are several options available to employees who want to obtain an estimate of out-of-pocket (BC Allowed Amount) expense:

-- Option 1: Call the Price Estimate line at (717) 531-3805. Callers will be prompted to leave a voice message. An estimate will be given by return phone call within two business days.

-- Option 2: Send an e-mail to the Groupwise address ("PriceEstimate"). An estimate will be given by return e-mail within two business days.

-- Option 3: Access the patient financial services Infonet site online. Select Blues Allowed Amounts for Penn State Hershey Medical Center employees. A list of commonly performed tests and their corresponding ranges of Capital Blue Cross allowed amounts are available.

To obtain a price estimate, employees must provide specific information on the service, including CPT code. CPT codes can be requested by the department providing the service.

Medical center employees or dependents who have questions about options for payment of their out-of-pocket expense or questions concerning billing should call Patient Financial Services Customer Service at (717) 531-5069.

(Media Contacts)

Last Updated March 19, 2009