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Life Health > Health Insurance > Life Insurance Strategies

Health Reimbursement Disclosure Attracts Broad Support

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Many health insurance company executives agree with patients and hospital executives that insurers should reveal how much they really pay for medical services.

About 83% of consumers, 77% of hospital executives and 60% of insurance company executives say insurers should disclose reimbursement rate for medical services, according to researchers at PNC Financial Services Group Inc., Pittsburgh.

PNC, a company that sells health care administration services to providers and insurers, paid an outside firm to conduct an Internet survey of 1,000 consumers and a telephone survey of 150 hospital executives and 50 health insurance company executives.

Some government officials and health care consultants say health insurers and providers should disclose the discounted rates insurers actually pay providers, not simply the providers’ list prices.

Although some experts have questioned whether consumers care as much about the reimbursement amounts that insurers pay as they do about their own out-of-pocket costs, 58% of participating consumers said knowing what hospitals or doctors charge for treatment and what insurers are paying for the providers’ services would influence where they seek care, PNC researchers report.

About 79% of the participating consumers said they would like to see an itemization of the portion of their health care bills that goes to administration rather than to clinical care, researchers said.

Hospital executives said 96% of all claims must be submitted more than once.

Executives at hospitals with electronic billing systems said they had to resubmit the average claim at least twice to get paid.

Executives at hospitals without electronic billing or claims submission systems said they resubmit typical claims about 11 times or more, researchers report.


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