IntroductionHistorically, there have not been open discussions about the cost of health care treatment and how this may affect the decisions being made. However, recently there has been a change of opinion on this subject. This is a new day in health care delivery in the United States. Patients and providers need to recognize that their roles and responsibilities have changed. This document has
been written to help both groups have a simple conversation about the costs of medical care and treatment as well as the patient's financial liabilities.
Providers themselves have not traditionally addressed the cost of required treatment with patients. These discussions have been reserved for office staff, insurance representatives, and human resource personnel. For years, PAF has helped patients who are well informed but are still looking for answers. They ask, "What will this cost me?" or "Can you help me determine my out-of-pocket expenses?" The best PAF could do was to look at the plan language and identify the co-pay, deductible, stop loss, premiums, and out-of-pocket maximum.
America is moving towards a team approach for health care services, because of multiple locations and providers. Therefore, it is becoming more difficult to determine cost and what out-of-pocket requirements patients are responsible for.
This publication was developed by the Patient Advocate Foundation. The information contained was prepared in response to frequently asked questions by patients. The purpose of this publication is to provide guidance about questions surrounding treatment options and how to discuss them with your physician or patient.