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Calif. medical group among first to offer price list

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A California medical group has become one of the first large U.S. practices to publish prices for common procedures. To date, a growing list of hospitals have begun to post pricing, but medical practices have not jumped on the bandwagon as enthusiastically. Torrance, CA-based HealthCare Partners Medical Group, a 500-physician primary care practice, has posted fees for 58 common procedures on its site, including chest X-rays, physical exams and flu vaccinations. The group's execs have named prices that are higher than what Medicare and Medicaid will reimburse, but lower than or equal to prices private health plans pay, representing the practice's costs plus a margin varying from procedure to procedure, said chief executive Robert Margolis. The group said it's hoping to help patients with high deductibles prepare for their out-of-pocket costs.

To get more information about this strategy:
- read this Los Angeles Times article

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Comments

"A physical exam ranges from $149 to $160 for a middle-aged patient." Last year, I had an employment-required annual physical in L.A.. Being 54, I'd requested a PSA, and wanted a cardiac panel to see what my cholesterol was. When the statement from the insurance company arrived, I was astounded that the total submitted was around $849! A whole battery of tests (many of which were not indicated, according to my research) were being billed, as well as a double-billing for venipuncture, which only occurred once. Eventually, insurance paid about a third; another third was written off, and I was presented with a balance due of $250. The physician had been referred to me by someone at the hospital where I worked, as he was on staff there. When I called to dispute the lab tests, I was never able to speak directly with the physician. Instead, his receptionist relayed information back and forth between the physician and me. Because I continued to protest the volume of lab work done, the receptionist told me that the doctor knew I was staff at the hospital, so he would discount my bill 50%. Thus, I ended up paying $125. As a final twist of irony, my employer declined to reimburse me the charges under California's preventative healthcare statutes, saying that neither the hospital nor my (travel company)employer had required the tests! BRAVO for these proactive people for letting the consumer decide!

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