Columbia, S.C. – BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan of South Carolina members preparing for medical services can now go to an online calculator to compare costs and estimate their share after their health plans pay.
The National Treatment Cost Estimator uses an aggregate of 12 months of claims data from Blues plans nationwide to identify the cost range of a medical service and matches it with the individual’s health plan requirements for copayments, deductibles and coinsurance to estimate the individual’s share.
For example, the tool will show that the total cost of a knee replacement at a specific hospital may be $12,000 to $15,000, but it may vary at another hospital. Members can see the comparisons, and the tool will assess their estimated portion of the bills, taking into account their copayments and what they have already paid toward their deductible.
The tool sheds light on the cost of 59 elective procedures at specific area hospitals, ambulatory surgery centers, and free-standing radiology centers for inpatient, outpatient and diagnostic services.
The estimator is unique in that it is the first to link Blues cost data to the member’s personalized benefits. Other cost estimators have used non-comparable public or government based data, rather than Blues data and have not gone the next step to customize it to the individual’s health plan requirements.
Integrated with the Blues’ nationwide Doctor and Hospital Finder, which provides search capabilities and hospital quality data, the tool can be used to search in any ZIP code in the United States.
“Until now, it’s been a mystery for consumers making health care decisions as to how much a service will cost them. One surgery can entail separate charges from a surgeon, an anesthesiologist, the inpatient or outpatient facility, and labs, and none of those entities can give the patient an overall cost estimate in advance nor can they estimate the patient’s share,” said Dr. Laura Long, BlueCross’ vice president of clinical quality and health management.
“Our members can now research costs based on their personal benefits, alongside quality information. Our tool more closely aligns shopping for health care treatment with shopping for any consumer product or service,” she said.
The calculator can be found on the secure member website, My Health Toolkit®, at Member.SouthCarolinaBlues.com for BlueCross members and is available to BlueChoice HealthPlan of South Carolina members at Member.BlueChoiceSC.com.
Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina are independent licensees of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises more than 40 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.