Treatment Cost Estimator

Our online tools on myRegence.com give users access to more information about:

• Cost
• Quality
• Other aspects they consider important when making value-based health care decisions

The Treatment Cost Estimator enables estimates at the:

• Treatment level (e.g. diagnosis through episode completion): Network average regional costs
• Encounter level (e.g. services from check-in through check-out for a visit or stay): Provider-specific costs
• Service level (e.g. a single procedure): Provider-specific costs

This tool takes into account where a member on select products is on his or her benefit accumulators and provides a member out-of-pocket cost estimate.

These cost estimator tools enable members to:

• Create a health care budget
• Build a knowledge base that encourages improved dialogue with their physicians and other health care professionals
• Compare and contrast treatment options based on costs and the components of a treatment (e.g., services and time)

All members have access to the network average regional cost estimates.

All of our members (excluding Regence MedAdvantage and Federal Employee Program [FEP]) have additional access to provider-specific estimation functionality including:

• Estimates for a single procedure or encounter
• Ability to base the estimate on selecting a physician or other health care professional and, if appropriate, a facility
• Estimates for services performed at a facility are shown along with estimates at other facilities that are nearby the provider
• Known affiliation status between a professional provider and facility are reported
• Blue Cross and/or Blue Shield Plan (Blue Plan) patient volumes for select services at facilities are displayed for estimates at the encounter level

When calculating the member out-of-pocket estimate, the estimate includes information about the member’s:

• Deductible
• Out-of-pocket maximums
• Cost share information (including coinsurance and/or copayments)
• Accumulators (i.e., the amount of deductible met by processed claims)

Note: The Price by Provider is based on the member’s benefit plan, so it can only be accessed and viewed by Regence members.

Cost information is only one component of making informed health care decisions. We plan to continue expanding our online content to provide members with more information on the cost and quality of health care services.