Dr. Jonathan Kaplan is a board-certified plastic surgeon based in San Francisco, CA and founder/CEO of BuildMyHealth, a price transparency-lead generation platform. He is also the author of a forthcoming book on price transparency and its benefits to the healthcare establishment and all Americans.
With the PTC model, providers can remain independent, continue "driving the bus," generate revenue for their practice, treat more patients virtually and scale their practice like never before.
For patients that are uninsured or not using their insurance and choosing to pay out of pocket, providers are required to give a patient an estimate of all reasonably expected costs ahead of time, referred to as the Good Faith Estimate (GFE).
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
This legislation has the potential to drastically reshape the economics of healthcare in America, but it remains unfamiliar to those it affects most—namely, patients, doctors and outpatient surgery centers.
While hospitals are slow to comply with the price transparency rules, full compliance will eventually mean hospitals provide “machine readable files” with thousands of lines of pricing data.
A robust price estimator should incorporate AI into its pricing calculations by recognizing that any estimate should automatically “link” and merge the hospital facility fee, physician professional fee and other billable fees into a final patient estimate.