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Compare Cost & Quality

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Compare Cost & Quality

You should know that cost and quality of care is different among doctors and hospitals. That’s why we provide you with the information you need to make the best choices for you and your family. Our care comparison tools help you find the highest quality of care at an affordable price.

Cost is important.

Identifying how much a procedure costs and what doctors and hospitals charge is important—especially if you want to save money. So, knowing hospital and doctor fees helps you make a more informed decision and helps stretch your health care dollar. Generally, the less you are charged, the lower your out-of-pocket costs will be.

Quality of care is equally important.

When it comes to choosing a doctor or hospital, you need a lot of information. How safe is the hospital? How successful are their outcomes? How effective is my doctor compared to other doctors? Now, you can see what many other patients like yourself have experienced. Our online directory lets you read and write reviews and rate your own patient experience!

It all starts with our online Doctor/Hospital Finder.

Of course, our online directory allows you to search for doctors and hospitals. But now, members can register for/login to Self-Service to check out costs, quality of care and patient reviews.

Doctors’ Cost & Quality Ratings

Where can I find cost and quality ratings for my doctor?

Our online directory, Doctor & Hospital Finder, provides you with these ratings.

  • Login to Self-Service
  • Choose the “Doctors & Hospitals” tab
  • Click on the “Doctor/Hospital Finder” link
  • Click on the “Doctor” button and search for your doctor

The quality and cost rating appears to the right of the doctor’s name.

What does a doctor’s quality rating mean?

This rating shows you how effective each doctor is as compared to other doctors in the same specialty.* The rating is symbolized by stars:

*** Excellent Performance
**  Above average performance
*   Average performance

What does a doctors’ cost rating mean?

This rating shows you each doctor’s cost of care rating as compared to other doctors in the same specialty.* The rating uses the following words:

"Lower" - lower in cost compared to other doctors in the same specialty

"Average" - average in cost compared to other doctors in the same specialty

"Higher" - higher in cost compared to other doctors in the same specialty

Compare up to 3 doctors at a time!

*Not all specialties have quality measures; more will be added as we receive additional measurements.

A provider’s total cost rating is calculated using case-mix adjusted episode groupings, which include professional, hospital, ancillary, and pharmacy costs. Blue Cross of Northeastern Pennsylvania makes every effort to ensure a fair analysis is performed for all providers.

As of publication, this is the most current information. It is subject to change at anytime. Please check https://findadoctor.bcnepa.com/ for the most up-to-date information.

 

Read real reviews from patients, just like you!

Use our Patient Review of Physicians (PRP) tool to find out what other Blue members have to say about local doctors and share your own experiences as a patient.

How do I rate my doctor?

  • Login to Self-Service
  • Choose the “Doctors & Hospitals” tab
  • Click on the “Doctor/Hospital Finder” link and search for your doctor
  • Click on the doctor’s name
  • Select the “Patient Ratings” tab
  • Click on the “Rate This Provider” button

If you plan on traveling, you’ll want to use the Blue National Doctor & Hospital FinderSM website to read reviews from other Blue Plan members on doctors across the U.S.

A number of steps are in place to ensure that patient reviews deliver valid and trustworthy data:

  • Use of a national question set
    Patients review their doctors using a nationally consistent set of questions that covers various aspects of their visit.
  • Authentication of all Blue members
    Only Blue members who login through “Self-Service” at www.bcnepa.com can write a review. This ensures that the reviews are limited to Blue members.
  • Validation of all Blue members writing reviews
    Blue Cross of Northeastern Pennsylvania members must verify they have seen the doctor or professional provider that they intend to review before they are allowed to access the review form. The verification takes place through a member attestation.
  • Open text comment
    For security and privacy purposes, reviews that contain user-generated content (such as free-form comments) will undergo both software and human review for appropriateness before the content is displayed. All submitted reviews are posted within 2 business days.
  • Frequency of reviews
    Frequent reviews for similar ongoing experience can skew a provider’s rating. BCBSA has set the limit on reviews by the same Plan member to 1 review every 7 days.
 

As of publication, this is the most current information. It is subject to change at anytime. Please check https://findadoctor.bcnepa.com/ for the most up-to-date information.

Hospitals’ Cost & Quality Ratings

Where can I find my hospital’s quality ratings?

Just visit our online directory, Doctor & Hospital Finder.

  • Login to Self-Service
  • Choose the “Doctors & Hospitals” tab
  • Click on the “Doctor/Hospital Finder” link
  • Click on the “Facility” button and search for your hospital

The "overall quality" rating appears to the right of the facility name, indicated by star symbols.*

***** Better than expected
***    As expected
*       Worse than expected

Where can I find estimated costs for a specific treatment in a hospital?

  • Login to Self-Service
  • Choose the “Doctors & Hospitals” tab
  • Click on the “Doctor/Hospital Finder” link
  • Click on the “Facility” button and search for your hospital
  • Select a treatment from the menu provided

The price range appears to the right of the facility name, under the “Est Costs” header.

What does the “estimated costs” rating mean?

This rating shows you a range of costs for common treatment in a hospital. This estimated cost can help you determine if your out-of-pocket costs may be higher or lower at another hospital. 

Is there more?

Absolutely. Just click on the facility name for a profile with more detailed data, including:

Clinical Ratings - rates the clinical outcomes for specific procedures in that hospital
Patient Safety - rates the quality of care for possible in-hospital complications
Care Ratings - rates the quality of care for various treatment types

Finding the right doctor or hospital is easy!

  • Check out your doctor and hospital’s quality ratings.
  • Compare costs before having treatment.
  • Read and share your patient experience with others.

Questions? We are here to help. Call a service representative at the number on the back of your ID card.

As of publication, this is the most current information. It is subject to change at anytime. Please check https://findadoctor.bcnepa.com/ for the most up-to-date information.