Sutter Health Plus offers its communities affordable access to high-quality care. It is committed to supporting efforts that provide meaningful information, tools, and resources to help members better understand their coverage and out-of-pocket costs.
Sutter Health Plus is disclosing in-network provider negotiated rates and historical out-of-network allowed amounts and the associated billed charges through machine-readable files in accordance with the federal Transparency in Coverage Rule. Data in the machine-readable files is updated monthly.
Sutter Health Plus is in the process of implementing a real-time benefit cost estimator tool that will allow members to understand and compare their personalized out-of-pocket costs for covered in-network services with individual-specific accumulators. The price comparison tool will list 500 items, services, and prescriptions drugs identified in the final rule, also called “shoppable services."
Members should refer to their benefit plan documents available on the Member Portal to better understand their out-of-pocket costs, such as copays, deductibles, or coinsurance. Members can also call Sutter Health Plus Member Services to help them better understand this information.
If you have additional questions, contact Sutter Health Plus Member Services weekdays, 8:00 am–7:00 pm, at (855) 315-5800.