Dec 07, 2022
UnitedHealthcare will provide members with a new tool to estimate and compare select health service costs based on CAA requirements.
Beginning Jan. 1, 2023, price comparison information for a specified list of 500 items and services is required for members in group health plans, with all covered items and services to be available for Jan. 1, 2024, as outlined in the “Transparency in Coverage” rule.
UnitedHealthcare will provide members with a Consumer Price Transparency Tool (CPTT) based on the new requirements. Members who already have cost comparison tools on their member portals can continue to access and use these as they do today. Additional functionality such as billing code search and “sort by cost or distance” are being added as part of the CPTT regulation. Members who already have the estimator tool will continue to have access to all existing care paths.
Customers who do not have a tool today will be able to access the CPTT Cost Estimation Tool for the 500 items and services. The Centers for Medicare and Medicaid Services (CMS) has a list of the 500 items and services that can be estimated using the tools.
With these tools, members have access to information — comparing prices based on codes and care provider options — to estimate their own out-of-pocket costs before receiving care. However, final care costs may vary from estimates and estimates are not a guarantee of coverage.
Key highlights
- Members who use cost estimation tools today as part of their portal experience can continue to access and use the tool in the same manner on Jan. 1, 2023.
- Members who do not have a cost estimation tool will be able to access a cost estimation tool available through their member website, supporting only the CMS-required 500 shoppable services.
- Members will have a variety of ways to search, filter, and print estimations.
- The cost comparison information is available through the self-service portal.
- Customer service is available to assist members with their estimate results, provide a written estimate with branded letterhead, and answer questions.
