Pricing Transparancy: Definition
Patients today want and expect to have pricing information when 'shopping' for elective healthcare services. The AnalyTXs AllPayor System uses your hospital specific claim, payment and payor contract information to compute an estimated 'out of pocket' amount so you can provide advance and accurate procedure specific quotes for your patients.
Each hospital has a unique pricing structure which is a product of their operating costs, capital structure, teaching mission and their medical staff’s practice patterns and training, along with the hospital’s mission, unique state mandated standards of care, contract negotiating clout, nurse staffing levels, and too many other factors to list here.
Each patient seeking care has a unique health status reflecting factors such as age, overall physical condition and may have complications such as diabetes, high blood pressure or heart disease. The patient has also selected or been provided their particular insurance coverage which can have various deductible and co-insurance requirements as well as the physician they have chosen to render care.
The AnalyTXs AllPayor System uses all of the hospital's specific claim data, payment data and negotiated payor contract terms, operating through MCA's ASP Oracle database, to instantly abstract that data and produce a visit specific price quote.
