Talk to Your Doctor and Hospital: 

Well-informed patients, who actively participate in their medical care, seem to do better than more passive patients. Ask questions about your diagnosis and proposed medical care; written information may be available. If the terms are too technical, ask what they mean. Clear information will help you more successfully follow your doctor's advice! This report is one tool to help you be a more active participant in the health care system; use it as a guide.

• Ask your physician which Diagnosis Related Group (DRG) category might be comparable to your condition.
• Review the number of patients treated at each hospital, the average length of stay and the average charges foreach of the severity categories. Check the inpatient quality indicators (www.cohospitalquality.org) if they are related to your condition or proposed procedure.
• Ask your physician and hospital (start with a patient representative or admissions counselor) how your condition and health status might affect costs, procedures, and length of stay.
• Ask your insurance company what is covered under your plan and what you will be expected to pay out-of-pocket for the proposed medical care. If you are concerned about your ability to pay, talk to a financial counselor at the hospital prior to admission if possible.

Here are some questions to ask when your doctor recommends tests, surgery or other procedures:

• What operation, treatment, or tests are being recommended? Why?
• What are benefits, risks and alternatives? What could happen if it is not done?
• How many of these cases has the hospital staff cared for or the physician treated?
• Will the outcome of a test affect treatment?
• How soon does an operation need to be done?
• What are the qualifications of the surgeon, anesthesiologist or other key health care providers who will be involved?
• Can you receive the care as an outpatient without staying overnight in a hospital?
• How long will recovery take? How limited will activity be during recovery?
• What kind of pain will there be after surgery? How will it be managed?
• What are the charges and fees?
• What additional charges may be incurred? (For example, will there be a bill from a laboratory or a medical specialist to read an x-ray or other test?) Will there be other consulting specialists?
• Will Medicare and/or other insurance cover charges? Will the physician accept the insurance payment in full? Do the physicians accept the same insurance as the hospital? (They may NOT.)
• Is home health care an option?