It Costs How Much?
Patrick Kelly’s receipt of the Explanation of Benefits for his colonoscopy served as the catalyst for recollections of his interactions with providers and staff members in preparation for and after his procedure. Some of these recollections raised legitimate concerns about informed consent and price transparency. A review of the Explanation of Benefits reminded the Patrick that even an attempt to explain prices for procedures and services after they have been billed may be difficult to understand. Determining the true cost was further complicated when coordination of benefits was necessary because of coverage by a second insurer.
- Explain the concept of price transparency as it applies to health care.
- Describe the necessary conditions of informed consent. Interpret when these conditions fail to be met.
- Analyze the elements of an Explanation of Benefits (EOB) and determine whether price transparency is facilitated by the EOB.
Explain how coordination of benefits occurs when a patient is the beneficiary of two different health insurance policies.