Pricing Transparency

The Centers for Medicare & Medicaid Services (CMS) has enacted pricing rules that include requirements for hospitals to offer more transparent prices to patients for the items and services they provide.

While implementing these complex rules can be time-consuming, our turnkey Pricing Transparency solution enables hospitals to lay the groundwork needed to comply with the mandate. Our Pricing Transparency solution addresses the two major components of the CMS requirement: 1) publishing the Charge Description Master prices with the associated payor-specific negotiated rates, and 2) publishing the detail for the 300 shoppable services.

Key Features

  • Creates a publishable Excel file(s) which includes billing code, HCPCS, or other identifiable feature; price; payor-negotiated rate; and, de-identified minimum and maximum rates
  • Produces a publishable Excel file(s) which includes shoppable services as identified by HCPCS, DRG, or other identifiable feature; services typically provided with the shoppable services; a standard for the inclusions of services in the analysis; and, each price for the primary and included service
  • Tailors different strategies for individual hospitals
  • Offers quick implementation—no software to install
  • Provides support by our expert consultants

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