Negotiation Process:
Reason for HealthUS.us
Our site's purpose is to negotiate out-of-pocket medical price rates between health care providers and patients. HealthUS.us is useful to patients with no or incomplete insurance coverage. Similarly, the system can be used by any of the 67 million foreign travelers visiting annually the US mostly for touristic but also medical reasons (i.e. Canadian citizens visiting the US in order to expedite medical tests/procedures that would be at times delayed in Canada).
Health care providers will look forward to our system since we can open the use of their facilities to a relatively large group of patients that otherwise will be blocked to seek care.
The patients' negotiation process is driven by parameters placed in by the patient and providers. In the current format we'll use only two simple parameters: age and income. While all patients will benefit from a reduction in cost using this system, older and lower income patients will likely benefit from higher discounts.
The higher one patient's age the higher will be the chance that she or he will use health care services, hence the negotiated price per each item will be lower.
The lower the income the lower will be the negotiated price per item, helping in this way patients and families in need. The threshold used in our trial algorithm is $48,000.00 per year (approximately 400% of federal poverty limit).
This service does not require an upfront premium. HealthUS.us will retain 7% of patient's payment at the time a test or medical procedure is ordered.
Site navigation
A. Here is the patient's website navigation sequence: 1) Hit the "Patient" button. 2) Register and establish in what income and age bracket you are (these are your negotiation parameters). 3) Sign-in using the email and password established. 4) The following screen will list the items offered by various providers for price negotiation. Select the medical items you want to negotiate for with the affiliated provider or providers. 5) Hit "Negotiate with us". 6) The following screen lists the negotiated prices and percent discounts for the items selected. By clicking "Complete negotiation and save your results" the system will lock-in for an established period of time the prices you negotiated. You can order the test ordered by your physician using the same website. Select from the list of negotiated medical tests/procedures the items indicated by your physician and press “Order for the tests/procedures indicated by your doctor'. This will take to a payment summary page listing the total sum to pay and then by a page where you can pay electronically for tests or procedures.
B. Setting the providers negotiation process sequence. If a medical provider is looking to set his own price-negotiation algorithm please follow this sequence: 1) Hit the "Provider" button. 2) Register. 3) Sign-in using the email and password established. 4) On the "Home" screen use "Select items for negotiation" to view the items that the provider allows the health-care users to price-negotiate. One can define new items by using the button "Define Negotiation Items" followed by giving a name, a definition and submitting the item, which inserts the latter into a drop-down list under “Define Negotiation Items“. From this drop-down menu one can select any item of interest that will then be transferred into a database by using the button "Add Item in Provider's Database". Here the provider will introduce the criteria brackets that allow a change in price from the standard price to the negotiated one. In order for a price-negotiation to happen one has to introduce the two bracket values for all criteria (in this case age and income). One of the income thresholds, either the maximum or minimum need to preferably be $48,000.