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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

January 2016

New Cost Estimator Tool Coming to Maine

A new online health care cost estimator will soon be available to Maine members enrolled in national plans offered jointly by Harvard Pilgrim Health Care and UnitedHealthcare. With a targeted go-live timeframe of late March, myHealthcare Cost Estimator will replace the Treatment Cost Estimator tool in Maine. In Massachusetts and New Hampshire, myHealthcare Cost Estimator is currently available.

By using a secure login, members enrolled in products offered through Passport Connect and Compass (Choice Plus and Options PPO) may access myHealthcare Cost Estimator. This new tool features an improved design and more detailed information about estimated costs of care, services provided, and the nature of those services. This information can help members better plan for treatment and out-of-pocket costs. Among the improvements:

  • Instead of offering only cost ranges, specific total cost estimates will now be displayed for the services in the treatment care path (episode). The care path includes the initial office visit, specific procedures involved, and associated follow-up care. Costs will be measured at the care path level to ensure that estimates are complete and members are aware of the services they should expect to receive.
  • Cost estimates for facility and professional services will be presented separately, rather than as a combined total.
  • Members will be offered descriptions of the relevant medical procedures and treatments.
  • Estimates will be based on provider-specific costs for hospitals, physicians, and facilities.

The fees and rates used to calculate cost estimates will be based on the current applicable fee schedule or rate for the specific service and facility or physician. However, when a set fee schedule value is inapplicable or unavailable, estimates will be based on claims data.

Providers can access the tool through UnitedHealthcare’s online provider portal. For more information, please contact the Provider Service Center at 800-708-4414.

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Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator