University of Washington Medical Center (UW Medical Center) has settled a class action lawsuit initiated by Heidi Rothmeyer, who was treated at UW Medical Center-Roosevelt.
Rothmeyer had challenged the reasonableness of the charges for the services she received.
The settlement has two key features: The first is to take steps to help patients better understand the charges for the services they receive, and to help them estimate, in advance, what their personal out-of-pocket expenses will be based on their insurance coverage. UW Medical Center is implementing a number of tools and procedures that will allow this to occur. The second is to implement an overall pricing reduction of approximately 25 percent for minor surgical procedures. Superior Court Judge Gregory Canova has given the settlement his preliminary approval and set a final approval hearing date of Dec. 1, 2006.
“We think it’s important that our patients understand our billing process and these new tools will make that possible,” said Lisa Brandenburg, interim executive director of UW Medical Center. “Helping patients calculate out-of-pocket expenses will allow us to work more closely with the insurance industry to provide better service.”
UW Medical Center officials believe the billing for the procedures that were the subject of Rothmeyer’s suit was legal and consistent with industry practice. The billing rates have been accepted by Medicare and Medicaid and were negotiated with insurers. UW Medical Center agreed, however, that its billing practices should be more easily understood by the patients who use UW Medical Center’s services and agreed to the reduction in future charges for minor procedures.
To make sure the new processes and tools are easy to use, implementation is being completed in phases over a 12-month period. The changes include:
- A process to provide patients, upon their request, with estimates of the charges they will incur prior to services being provided
- Enhanced Web site presence including frequently asked questions related to billing
- A Web-based tool to help patients calculate their out-of-pocket expenses
- A Web-based ability to seek assistance regarding billing questions
- A new, easy to understand bill
- A new system for tracking billing questions to help with process improvement
- Enhanced signage and brochures outlining billing practices
“Patients should be able to know the cost of having a procedure performed at a hospital-based outpatient clinic instead of at their doctor’s office or a neighborhood clinic. This settlement will provide better information for the patient as a consumer and reduces the UW Medical Center’s charges for minor surgery procedures,” said John Phillips, the managing partner of Phillips Law Group, PLLC, which represented Rothmeyer in the lawsuit. “We believe that Ms. Rothmeyer has initiated a move toward greater transparency in billing and fairer pricing in relation to minor surgical procedures, not only at UW Medical Center, but for hospitals throughout the area.”
For more information on UW Medical Center’s initiatives, please visit the Web site http://www.uwmedicine.org.