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Online tool to help consumers estimate medical costs
■ The nonprofit FAIR Health database was funded by a settlement between New York's attorney general and several insurers.
By Emily Berry — Posted July 20, 2011
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The FAIR Health online medical cost lookup tool established as part of multiple insurers' settlements with former New York Attorney General Andrew Cuomo is set to launch in August. A website for the nonprofit will grant public access to a vast database on out-of-network claims that is supposed to reflect the best available information about what physicians nationwide charge for any given service.
The New York-based independent nonprofit FAIR Health expects to unveil the site Aug. 1, FAIR Health President Robin Gelburd told American Medical Association members gathered for an educational session at last month's AMA Annual Meeting.
The cost lookup tool will be part of the FAIR Health's consumer website (link). It will allow anyone to see a representative range of charges for a given procedure by geography. The user can enter a Current Procedural Terminology code or medical condition to find out what local doctors typically charge.
The goal is to give patients an idea of what they will be billed if they choose to see an out-of-network physician, so they can better prepare to meet out-of-pocket expenses or select a physician who charges a lower-than-average fee. The information is free and based on independent data.
The establishment of the FAIR Health consumer site was a central part of agreements between the New York attorney general's office and UnitedHealth Group, Aetna, Cigna, WellPoint and several other insurers in the state in 2009. None of the insurers admitted wrongdoing. But they collectively pledged nearly $100 million to fund FAIR Health, and United agreed to discontinue selling its Ingenix databases as soon as FAIR Health could replace them.
Before the settlements, insurers determined "usual, customary and reasonable" charges based on a methodology few were privy to and which Cuomo said was fed skewed data that served the interest of insurers rather physicians and patients.
"We have tried to fulfill this core component of our mission as responsibly as possible," Gelburd said.
She said FAIR Health posted searchable cost information for dental procedures April 1, and that experience helped it prepare for launching the medical cost lookup tool.
