Should Nurses know procedural costs?

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I got into a discussion on Facebook regarding lack of transparency of healthcare costs. A patient was asked by a nurse to sign a form saying that if insurance does not cover the procedure/test, the patient will assume financial responsibility. He asked the nurse how much the test was and she didn't know. My question is: should the nurse know the prices of procedures and tests he/she is involved in?

Specializes in ICU.
I think it should depend on where you work and the types of patients you get.

Absolutely. I don't think it would be advocating for my patients to know the cost of a procedure. I think it would hurt them. If I said, "You have a medication that is very toxic to your veins running, and we need to put a central line in - that is going to cost you $2,000 (or whatever, I have no idea)," the patient might say, "No way!" And then when that Levophed infiltrates and the patient has to have surgery to remove the necrotic tissue on their arms because they refused a central line because it was expensive, I would feel like crap.

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Specializes in Psych, Addictions, SOL (Student of Life).

I don't think we need to know billing costs for procedures because depending on insurance and the capitated rate the procedure might cost anywhere from $5.00 to several thousand. Cast in point when I had my son in 2002 my total out of pocket cost for the entire pregnancy was $10.00. When my son went to the NICU for 11 days the total cost from a bill mistakenly sent to us was over $100,000.00 of which we paid nothing out of pocket. I don't believe he needed to be there that long and he would have been there longer if we (my husband and I) hadn't pushed for his discharge.

That being said I do think nurses should be generally aware of the day to day costs of running a medical practice/hospital and medical supplies. I see huge amounts of waste committed by nurses who then complain about raises and cost cutting measures being taken by hospitals. Yes it might seem like only a $2.00 roll of tape but when thousands of them walk out of the hospitals everyday attached to our hemostats or stethe0scopes it represents a substantial loss of revenue for the hospital. Just as a nurse who habitually comes in late to work ends up costing a hospital thousands in overtime costs for the employee's who have to stay over to cover for them.

Just food for thought

Hppy

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Specializes in ER, ICU.

Nope, mainly because, unlike in a store, there is no one price for things. They are charged differently depending on many factors, like your insurance, or whether you even have insurance. Don't go there...

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Specializes in Critical Care.

What the hospital charges and the amount insurers reimburse are two different things, but typically patients aren't asking at what rate an insurer will reimburse, they're asking what the hospital charges which actually is a set, single price at each hospital.

When you call your billing department to inquire about what a patient will be charged, all they are doing is looking on price list, similar to a menu at restaurant and about as complicated; if you can understand a restaurant menu you can understand a hospital's charge list. Trying to understand what amount an insurer will reimburse for is much more complicated, but luckily that's not what the patient is asking.

At facilities I've worked at, figuring out what is charged for a procedure is no more complicated than looking up what's for breakfast tomorrow; I go to the food service site, click on patient menu and look for "Wednesday breakfast". To look up the charge for a procedure I go to the financial services site, click on "procedure charge list" and look up "diagnostic angiogram" and there's the charge. There are often sub-types, although even if I'm not sure what sub-type they'll be charged for there is still a range of prices to give. If I were to call the billing department they would be looking up the charge on the exact same list I can look at, and I don't think looking at a straightforward price list is something nurses should need assistance with, any more than they should need assistance from the food services staff to interpret the menu.

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Specializes in Med/Surg, Academics.

I just searched for my health system's pricing list on the website. I'm not at work, so I don't have access to the intranet. Know what? The hospital website states that actual price charged has many variables (it lists some of them), and it directs inquiries to the billing department with a phone number, email, and hours of operation. Nowhere does it say, "Ask your nurse."

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I worked in managed care and health insurance for many years. The lack of transparency in this industry is NO mistake. Follow the $$. This is a capitalist society, and even non-profits must play ball.

It would be wonderful if nurses knew the real out-of-pocket costs and could legitimately advocate for their patients. But they don't. And they can't. It's by design. If your billing manager tells you TOMORROW that a level 3 office visit costs $125.00, you should refuse to quote it. Don't ever cross that line. Someone will make a liar out of you.

I'm not just a cynic; I know what I'm talking about here.

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What the hospital charges and the amount insurers reimburse are two different things, but typically patients aren't asking at what rate an insurer will reimburse, they're asking what the hospital charges which actually is a set, single price at each hospital.

When you call your billing department to inquire about what a patient will be charged, all they are doing is looking on price list, similar to a menu at restaurant and about as complicated; if you can understand a restaurant menu you can understand a hospital's charge list. Trying to understand what amount an insurer will reimburse for is much more complicated, but luckily that's not what the patient is asking.

At facilities I've worked at, figuring out what is charged for a procedure is no more complicated than looking up what's for breakfast tomorrow; I go to the food service site, click on patient menu and look for "Wednesday breakfast". To look up the charge for a procedure I go to the financial services site, click on "procedure charge list" and look up "diagnostic angiogram" and there's the charge. There are often sub-types, although even if I'm not sure what sub-type they'll be charged for there is still a range of prices to give. If I were to call the billing department they would be looking up the charge on the exact same list I can look at, and I don't think looking at a straightforward price list is something nurses should need assistance with, any more than they should need assistance from the food services staff to interpret the menu.

From the website of one of my area hospitals:

"xxxxx Medical Center makes no guarantees regarding the accuracy of the pricing information provided by this website. A final bill for services rendered at xxxxx Medical Center may differ substantially from the information provided by this website, and xxxxxx Medical Center shall not be liable for any inaccuracies."

You then have to check, "I understand".

Once you get to the actual price sheet, you see price ranges, which vary wildly.

It seems figuring out what is charged actually is more complicated then ordering breakfast.

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More importantly, providing a patient with that sort of information when asked is a core part of patient advocacy. If the costs of healthcare is not something a nurse is interested in then I'd argue they aren't interested in being the patient's nurse.

Please do make the argument that I somehow I am not interested in being the patient's nurse if I'm not interested in figuring out what their care is costing.

I'm interested in the logic behind that thought.

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