ClearGage vs. CareCost Estimate

Our secure payment vault, which meets PCI compliance standards, safely houses your patient's payment details. With the patient's approval, you can streamline the process by automating and collecting payments for a predetermined amount once the claim has been adjudicated. Healthcare practices can also gather copays from patients prior to care, using estimates to enhance financial management and facilitate plan activation, or they can process pre-authorized payments after care has been delivered. Additionally, a fully customizable online portal enables patients to make payments or establish payment plans while ensuring their payment information remains secure. To foster a more transparent financial experience, accurately estimating out-of-pocket expenses allows for early discussions on payment plans, ultimately leading to higher treatment acceptance rates. This approach not only benefits the practice but also enhances patient satisfaction and trust.

CareCost Estimate delivers a comprehensive solution tailored for infusion centers and specialized medical practices, addressing a frequent question from patients: what is the expected cost of treatment? By inputting details such as medication, dosage, and insurance information, staff members can quickly calculate the patient's out-of-pocket expenses, often in under 90 seconds. This estimate takes into account various elements, including Medicare Part B coinsurance, any secondary insurance, Medigap coverage, weight-based dosing, and potential vial waste considerations (JW/JZ). Additionally, it factors in any available manufacturer copay assistance programs and foundation grants that the patient might qualify for, ensuring that the provided estimate accurately reflects the patient's financial responsibility. Beyond just cost calculations, the platform also offers valuable insights into payer requirements, outlining necessary prior authorizations, step therapy guidelines, and site-of-care conditions, all derived directly from the payer's policy documents with relevant links for easy access. The pricing data is based on the CMS Average Sales Price files, which are updated quarterly, and importantly, since the estimates are generated within the browser, patient information remains confidential and is not sent to outside servers. Furthermore, CareCost enhances its offering by providing free resources on billing and coding practices, including infusion CPT codes, J-codes, and modifiers, as well as a quarterly Infusion Reimbursement Index that aids healthcare providers in optimizing reimbursement processes. This comprehensive approach not only streamlines cost estimation but also supports healthcare professionals in navigating the complexities of patient billing.