Frequently Asked Questions
What is Healthcare Bluebook?
Healthcare Bluebook’s purpose is to protect patients by exposing the truth about price and quality variation, and empowering patients to make informed decisions.
Shopping for a car or a new phone is easy. Shopping for healthcare is not. Healthcare Bluebook solves this problem by providing an intuitive, easy to use web and mobile platform that enables patients to look up services and compare providers on cost and quality. Knowing price and quality before receiving care can save you hundreds or even thousands of dollars and ensure that you receive the best possible care.
What does Bluebook do?
Healthcare Bluebook helps you save money on healthcare services. Did you know that in-network prices for the same procedure can vary by over 500%, depending on the facility you choose? Our web and mobile applications make it easy to save money on hundreds of the most common medical services and procedures by showing you the cost ranges in your area, and providing you with a selection of Fair Price providers.
What is the “Fair Price?”
The Fair Price is the price that a person can expect to pay by being a prudent healthcare consumer: someone who does basic research to determine which facilities offer the best price for a specific service.
Bluebook Fair Prices are based on the actual amount paid on the claim, not the billed amount, and reflect the discounts that the health plan has negotiated with the facility.
For services that include more than one provider, separate Fair Price amounts may be shown for facility, physician and anesthesiologist.
How do I find a Fair Price?
Finding a Fair Price provider is easy using Healthcare Bluebook. Type in a search term or use the drop down menus to search for a particular service. Select the procedure you are looking for from the search results. After the price page loads, review the price range in your area and find the local Fair Price for your service. Notice that prices are color coded. Green indicates that the price is at or below the Fair Price, yellow is slightly above the Fair Price, and red are the highest prices. Then, scan down the page and review provider options for the service. Bluebook conveniently color codes all the provider options to make is easy for you to identify those providers with prices at or below the Fair Price.
Don’t see a particular provider? You can always call and ask your provider for a price estimate based on your insurance company rate. Compare the provider’s price estimate to the Bluebook Fair Price to determine whether or not the provider’s price is in the fair range.
How does Healthcare Bluebook determine Fair Prices?
Bluebook has a proprietary analytics system that is used to evaluate the allowed amounts (or discounted amounts) from medical claims and pricing and includes a variety of data sources to provide members with very accurate Fair Price information for healthcare services in their market. This system is used to develop the Fair Price and provider rankings in markets across the country.
Why don’t you display the exact price for each facility?
We provide price rankings instead of exact prices because, in some cases, additional services may need to be provided at the appointment that change
the overall cost. For example, a patient may expect to have an MRI without contrast. During the exam, it may be determined that contrast is needed for the MRI study. In this example, the actual MRI with contrast price will be different from the MRI without contrast price. However, our color rankings let you know that you are choosing a Fair Price provider, and that your services will be provided at or below the Bluebook Fair Price regardless of the exact set of services you receive during the visit.
What do the colors and symbols mean next to the healthcare facilities?
Color-coded cost symbols denote cost rankings for facilities to help you easily identify where a facility falls in comparison to the Fair Price. A green circle means at or below the Fair Price; yellow triangle means slightly above the Fair Price; and a red stop sign means significantly above the Fair Price. The providers are listed in order of lowest price to highest price.
Why do some Fair Prices have several components?
Many surgical procedures, such as a hip replacement or knee surgery, have multiple components and are based on a standard procedure without complications. The three major cost categories for most surgical procedures are:
Facility: Depending on the procedure, this may include items such as overnight stay, nursing, supplies, devices and medications.
Physician: Includes the fees for the physician performing the procedure and post-operative care.
Anesthesia: Includes the fees for the anesthesiologist and anesthesia and is based on the length of the surgery.
How often do you update cost information?
We constantly update the data in our system as we learn of price changes.
Why do some searches not include any green providers or return any facilities in my area?
In smaller cities or more rural settings, there might not be a Fair Price (green) facility in your immediate area due to the fact that there are very few providers in the area. In this situation, you might need to travel a bit to find a Fair Price provider. Additionally, Bluebook does not rank facilities for procedures that have little cost variation or for those procedures that a doctor is likely to perform in-office.
Is there a specific amount of time that my session will timeout?
Yes; your session will last for 20 min before timing out.
What is a Value Certified Provider?
A Bluebook Value Certified Provider (VCP) is a physician who has committed to helping their patients by adopting the principles of healthcare price transparency, including:
- Providing fair, open and transparent pricing for their patients in advance of care
- Referring their patients to Fair Price facilities when available and when medically appropriate
- Downloading and using the Bluebook mobile app
- Giving consideration to the financial 'side effects' associated with their treatment decisions
- Acting as a partner with patients seeking the best clinical AND financial outcomes
- Using the CMS or other applicable fee schedule for any Medicare or Medicaid patients
What kind of healthcare providers receive the VCP designation?
The VCP designation applies to any physician who agrees to honor the Bluebook VCP pledge. This includes doctors of medicine, doctors of osteopathy and doctors of podiatry.
What is a Featured Facility?
A Bluebook Featured Facility is a healthcare facility which has agreed to provide their patients with fair and transparent pricing by offering Fair Price assurances, special pricing or cash discounts for Bluebook members. Patients should always confirm pricing with the facility before scheduling an appointment. Anesthesia and physician fees, if any, are generally not billed from the facility and will vary. Patients should ask for a price quote for those services as well when confirming the price with the facility before scheduling an appointment. Pricing will vary based on insurance plan and is not applicable for Medicare or Medicaid recipients.
What kind of healthcare providers are eligible for Featured Facility placement?
The Featured Facility designation applies to any healthcare facilities which agree to the Bluebook Featured Facility agreement. This includes:
- Imaging Centers
- Sleep Centers
- Ambulatory Surgery Centers
How do consumers benefit from the VCP and Featured Facility designations?
The VCP and Featured Facility designations support our mission to help consumers save money on healthcare by making it easier to find the right provider at the best possible price. These initiatives aim to offer objective and trustworthy information for consumers as they search for fair prices and superior value.
How do providers benefit from the VCP and Featured Facility designations?
Value Certified Providers and Featured Facilities will gain favorable distinction for the high-quality, cost-conscious care they deliver and coordinate every day. The VCP and Featured Facility designations distinguish these providers for all patients to see as they make decisions on where to seek care for themselves and for their family.
What is a provider network, and how does it work?
A provider network is a group of providers who contract with a health plan to accept lower prices for their services. The term "provider" includes healthcare professionals and facilities, including doctors, hospitals, retail clinics, pharmacies, optometrists and many others. Health plans use provider networks in order to get better prices for their members.
Since most health plans include a provider network, it is important to know if your doctor or other provider is in the network ("in-network") since your insurance will pay a higher level of benefit for in-network providers. If your provider is not in the network ("out-of-network") you may have to pay significantly more for the service.