5 Ways to Help Uncover Hidden Costs in Medical Procedures

There’s no doubt about it: healthcare is getting more and more expensive. In 2021, people paid an average of 10% more than they paid in 2020, or an average of $1,650 per payer. And that’s just the beginning—out-of-pocket costs are expected to grow almost 10% per year going forward.

That price only increases if you need medical procedures or treatments. As a result, many of us try to find out pricing on particular treatments or procedures ahead of time. This is already a difficult task, as your health insurance plan will often impact how much you are charged overall. Your hospital may charge your insurance plan differently for saline, post-treatment care, and more. 

It’s these hidden costs that can drive up prices and lead to sticker shock when you do finally receive a bill.

What questions should I ask to uncover hidden costs?

You may not always be able to find out exactly what you’ll be expected to pay, but by doing your research and asking questions about your procedure ahead of time, you can better understand these costs and, potentially, get ahead of them.

  1. Find out if your provider is in-network. We don’t just mean if they accept your health insurance. They may accept your plan, but not your network, which is generally assigned with your HMO or PPO.
  1. Ask your provider to give you the CPT codes for the procedure you’re going to receive. 
  1. Ask your provider for additional charges associated with your treatment, along with the codes for those charges. These are often the hidden costs that drive up bills at the end of the day. Ask your provider about the cost of things like the following:
  • Interpreting test results
  • Providing or removing stitches
  • Services from other providers who may be involved (anesthesiologist, cardiologist, etc.)
  • Bandages, saline, test strips, and any drugs that may be administered to you during the procedure 

These all seem like they should be included in an overall price quote, but they often are not. If you are receiving a procedure at a hospital, you should take extra care to find out if any assisting physicians are within your network as well. 

  1. Provide your health insurance company with the procedure codes and find out, overall, what it will cost. You may have to switch between operators and departments to find someone who can provide an overall quote.
  2. Understand that you may still not be able to get a full picture of your bill. Healthcare practitioners and hospitals may offer discounts, particularly if you want to pay cash instead of going through your insurance company.

As you can see, even getting a ballpark figure of what you’re going to pay for a particular treatment or procedure can be a long, time-consuming process. It also makes comparison shopping even more difficult—assume you will need to set aside time for all of the steps above, multiplied by however many facilities or healthcare professionals you’re looking into.