"Cash pay" or "self pay" simply means that the patient pays with cash, check or credit card and not based on an insurance plan. Now we get to the confusing part:
Hospitals have different rates for each specific test, exam or procedure that they will list on their rate sheet called a “Chargemaster”. That is usually the highest price. They will then negotiate with insurance companies another rate that is lower than the “Chargemaster price”, and each insurance company may have a different rate for each of their different plans. This is where insurance companies let their customers know that they have procured significant cost savings for their customers with the “Negotiated price”.
The “Cash-Pay price” can oftentimes be significantly lower than both the Chargemaster price and the Negotiated price. This can be a very attractive and more affordable option for people without insurance, or those that might have a high deductible plan or that will not likely reach their deductible.
AMPT focuses on cash pay pricing because the pricing is more defined, understandable and relatable for the uninsured and underinsured population that is most vulnerable to medical debt and bankruptcy.
Trying to determine insurance pricing of healthcare with the dozens of plans and their associated copays, deductibles, etc. is much more complex due to all of these variables.
