This article is for physicians and clinicians caring for our members
We’re conducting our biannual update of our member cost estimation tools. The data is based on care rendered from October 1, 2018 – September 30, 2019, paid through November 30, 2019 under your contracted rates, including associated care rendered by other providers.
As you may recall, the Blue Cross Blue Shield (BCBS) Association, in partnership with BCBS plans including Blue Cross Blue Shield of Massachusetts, launched member cost estimation tools several years ago. These are designed to help BCBS members become more informed health care consumers and allow members to compare:
- The approximate cost of services and procedures that can be performed in a variety of settings (e.g., hospital outpatient and inpatient, freestanding imaging centers, ambulatory surgery centers).
- Average costs for services performed in medical group offices, including physician-specific costs for outpatient and imaging services.
The tool encourages HMO and PPO members to consult with their clinicians in making decisions about where to seek care. Members may also refer to our quality comparison resources and listings of our Blue Distinction Centers to help select a site of service based on both quality and cost.
You can view an explanation of our methodology with the included treatment categories and codes. Simply log in, go to Quality & Performance> Transparency & Product Design>Quality Transparency, and click Member Cost Estimation Tools Methodology and Code List. You can obtain a copy of your data from your Network Manager (log in and click on Contacts & Sites at the top of this page).
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