Aetna Payment Estimator Review
Aetna Payment Estimator estimates the cost of services for doctors and their patients. Our Aetna Payment Estimator review finds that the software automatically tallies the costs of medical services performed in real-time by using the member’s benefits plan details and provider fee schedules. The amount that isn’t covered is your out-of-pocket expense for the visit.
Free Car Insurance Comparison
Compare Quotes From Top Companies and Save
Secured with SHA-256 Encryption
UPDATED: Jun 28, 2022
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider. Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about life insurance. Our goal is to be an objective, third-party resource for everything life insurance related. We update our site regularly, and all content is reviewed by life insurance experts.
UPDATED: Jun 28, 2022
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider. Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
A certain unnamed TTAI staff member recently went in for their “free” annual physical. Many health insurers offer this as a preventative measure against major medical problems that may go undiscovered without routine screenings. Sounds simple enough…right? Wrong.
You probably already know that most doctor visits aren’t free, but just how much you’ll be on the hook for seems to be a mystery until the final bill arrives.
If you’ve been to your doctor recently, you likely heard the phrase, “we will bill your insurer and send you a bill for whatever they don’t cover.”
It can be a little disconcerting to think about the “surprise” bill you’ll get in the mail in the next few weeks.
But what if there was a magical way to determine exactly how much your bill will be? Enter the Aetna Payment Estimator.
What is the Aetna Payment Estimator?
NaviNet, the nation’s largest real-time healthcare communications network, has created a piece of computer software called the “Aetna Payment Estimator” that estimates the cost of services for doctors and their patients.
Simply put, the software automatically tallies the health care costs of medical services performed in real-time by using the member’s benefits plan details and provider fee schedules to provide an estimate of their financial responsibility.
The amount that isn’t covered is your out-of-pocket expense for the visit.
The simplest example would be calculating the cost of your copay, deductible and coinsurance and subtracting it from the cost of your overall visit. Anyone with private (non-employer sponsored) healthcare insurance knows this isn’t necessarily that easy!
(Can I get health insurance without a job?)
Compare Quotes From Top Companies and Save
Secured with SHA-256 Encryption
The Benefits
1. No surprises – this is the biggie. You can get an accurate estimate of a future bill today. Being prepared for a costly medical bill is helpful in more ways than we can count, not least of which is peace of mind.
2. Lower bills – You may opt to forego certain medical tests if you know they are not covered prior to having them performed. Anyone who has received a large surprise bill would likely agree they could have skipped a few of the “services” that ended up costing much more than they expected.
3. Better planning – Knowing just how much is due and when will help you set aside the necessary funds so you can pay the bill in full, as opposed to opting for a payment plan that costs you more.
Any Downside?
We’re glad you asked. First, if Aetna is not your healthcare provider, you can expect to do things the old-fashioned way, which means increased stress levels after your visit while you wait for your bill to arrive.
However, Aetna’s Payment Estimator is no perfect angel either. It relies on you selecting the proper procedures and services, and hoping they match up with those which your doctor uses.
If different codes are used, your estimate may be way off. The estimate could also be “unsuccessful” if the submitted procedure requires review, or if the provider does not participate with Aetna or the patient’s network.
Another potential drawback is that Aetna’s Payment Estimator provides real time estimates. This means your estimate may be “off” if you have visited multiple healthcare providers within a certain time frame.
There is no way (currently) for the program to differentiate between what you owe for “today’s” visit and “last week’s” visit. You will only see the grand total for all “claims” being processed at any given time. So your estimate will show the total amount due for all current charges.
Final Word
While this seems like a great idea, at the end of the day it’s just an “estimator.” In other words, expect prices to vary, and for arguments to ensue.
It’s certainly not a strong reason to stay with or switch to Aetna, but it is an added frill to increase transparency in the often overly complicated medical industry.
And it’s not necessarily always a great idea to make health decisions based on cost, especially if they’re pressing issues. Perhaps having a better health insurance plan is the way to go.
Take the time to compare health insurance quotes online and/or visit an independent agent to ensure you get the best deal for your health coverage needs.
Read more: Top 10 health insurance companies.
(photo: colinmford)
Compare Quotes From Top Companies and Save
Secured with SHA-256 Encryption
Editorial Guidelines: We are a free online resource for anyone interested in learning more about life insurance. Our goal is to be an objective, third-party resource for everything life insurance related. We update our site regularly, and all content is reviewed by life insurance experts.