Search & Save Engine

One Billion Searchable Price Tags

80% of working Americans never meet their deductible. That means most people are paying for every dollar of medical care out-of-pocket. You deserve to know the price of your medical care – before you buy it.

Search & Save Engine Features

  • Search by test name and zip code
  • Medical provider name, charge (retail price) and claim allowable (discount price) are displayed from lowest to highest
  • Search and save engine helps satisfy ERISA fiduciary for the health plan by providing members a tool to manage costs
  • One billion Medicare claims are searchable across all 50 states
  • No more secret pricing. No more surprise medical bills.
  • Self-insured organizations’ medical bills are made searchable so that their members can find affordable care with real price tags within their health plan

What Do the Left and Right Price Tags Mean?

Charge

(left hand price tag)

  • The retail amount
  • Represents your maximum financial risk
  • This is your bill if your claim is denied (happens 20% of the time) or if care is received out-of-network.
  • There are some non-hospital providers with low charges for care. This means your maximum financial risk is low.
  • Seek care with low charges to pay less and assume less money risk

Claim Allowable

(right hand price tag)

  • The discount price
  • The amount that’s really paid at the "counter"
  • Default price tag shown is Medicare fee for service payment
  • Medicare is the largest payer of health care, making it the only gold standard pricing in the US
  • Paying Medicare plus 20% as a cash price will save you much more than paying a “discount” price off the usually very high retail price
  • Self-insured organizations’ can have their medical bills pricing entered into our search engine so members can view real in-network pricing

The Four Price Tags of Medical Care

  • 1
    Charge (retail amount)
  • 2
    Claim allowable (health insurance company discount amount)
  • 3
    Cash
  • 4
    Medicare

Example

Provider Name

Abdominal & Pelvic CT

  • 1
    Charge + $1,500
  • 2
    Claim allowable - $800
  • 3
    Medicare - $300
  • 4
    Cash price target = $360
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$300 Medicare payment x 0.20 (20%) = $60;

Medicare + 20% = $360

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CareGuide Advocates reveals the high (charge) and low (Medicare) price per care item by provider name and test name. Our goal is for each and every one of you to have affordable access to medical care.

  • These four price tags are listed from highest to lowest
  • Cash price must be higher than Medicare as tax payer dollar must get the best deal or else it is medical provider fraud
  • 80% of people will never meet their deductible, so paying cash price saves the most money
  • Call the medical provider and ask for their best cash price for your care item
  • If it is at or lower than Medicare plus 20% rate, accept that amount in writing
  • Otherwise, offer to pay Medicare plus 20%