As a pediatric facility, communication regarding the patient's financial responsibility is solely with the parent or guardian. Getting accurate insurance estimates into their hands was a major struggle, and even combining phone and email outreach proved unsuccessful much of the time. Adding to the issue was that Cook Children’s had no way of seeing if/when estimates were viewed, therefore staff members were spending valuable time unnecessarily following up with patient families. The rare instances when everything went as planned and estimations were calculated and communicated ahead of time, there was a good chance the deductible would change before the DOS and a portion or all of the amount collected at the time of service would have to be refunded downstream. Their process was negative

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