New COVID-19 Testing Price Transparency Requirements Effective Immediately

November 20, 2020 By: Harley Ross

Increasing healthcare price transparency is a strategic objective of CMS, which has finalized rules regulating providers of COVID-19 tests. 

As part of an interim final rule, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency, published on November 6, 2020, and effective November 2, 2020, the Centers for Medicare & Medicaid Services (CMS) is requiring that any provider of COVID-19 diagnostic tests publish its cash price for COVID-19 testing.

The rule includes definitions of “provider of a diagnostic test for COVID-19” (or “provider”), “COVID-19 diagnostic test,” and “cash price” and requirements for posting cash price information online, or upon request and through signage (if applicable). This rule also gives CMS discretion to provide a warning notice, seek compliance with a corrective action plan, or impose a civil monetary penalty for noncompliance with the COVID-19 testing price transparency requirement.

We are at the very beginning of this multi-step price transparency initiative. Under this historic initiative, about 200 million Americans will gain access to real-time price information, enabling them to know how much their healthcare will cost them before going in for treatment. The goal of this initiative is to ensure every American knows how much their healthcare will cost in advance to allow them to make fully informed and value-conscious decisions.  

Technology companies are creating additional price comparison tools and portals that will further incentivize competition, as well as allow for unprecedented research studies and data analysis into how healthcare prices are set.

We’ve been speaking with many groups who are scrambling to find a tool that creates patient responsibility estimates that are also easy to use, and work well with their EMR system while adhering to government requirements.

Payer Price Transparency by Quadax integrates directly into your website reducing the need for ground-up, custom development work and:

  • Ensures compliance with new payer price transparency rules
  • Enriches the patient experience with an easy-to-use, personalized pricing calculator
  • Allows you to track and learn from patient-submitted estimate data

Informed patients are more likely to pay their bills. The right patient access platform will empower your staff to inform patients up-front while leading to higher patient satisfaction scores and increased reimbursement.

With our configurable Patient Access Management software and automated workflow, you can ensure successful outcomes at each patient touch point: insurance verification, patient pay estimates, medical necessity and propensity to pay, while merging front and back end functions, leveraging data and collecting payments upfront.

Let’s take on the revenue cycle together!

 

Harley Ross HeadshotHarley Ross is Executive Vice President and Chief Revenue Officer with executive oversight over the Revenue Cycle Services (RCS) division which supports Quadax’s full service revenue cycle platform. Part of his role is to lead and support go to market strategies for both existing and new products for RCS in support of new and existing clients. In his time with Quadax, he has a varied background spanning sales and client services leadership and has worked closely with product and operations to help grow the RCS division. Leveraging his experience and knowledge of software and technology that spans over 20 years, he is a passionate executive leader with a focus on delivering solutions to a variety of market segments which spans the spectrum of finance, revenue cycle, managed care, commercial sales and information technology with a specific focus on the laboratory, medical device, diagnostic and durable medical equipment (DME) segments.

 

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