Standard hospital charges
Per federal requirements, we have posted our current, standard charges for all procedures. We do, however, want to caution patients that these charges are what is billed to the insurance companies or government payer, not necessarily what a patient will owe. Each insurance company has a negotiated rate that determines what they will pay for a procedure or hospital stay. For an employer sponsored plan, the employer determines how much of that negotiated rate a patient will be responsible for. Medicare and Medicaid rates are determined by those government agencies.
The best way for patients to determine an out-of-pocket cost is to get a procedure code from your physician and then contact the hospital for a price quote based on their coverage plan. Patients should also keep in mind that care provided by physicians is billed separately by that provider’s office.
Beginning Jan. 1, 2019, the U.S. Department of Health & Human Services and Centers for Medicare & Medicaid Services require hospitals and health systems to post their “current, standard charges.”
Hospital charges refers to the amount a hospital bills an insurer for a service. For most patients, insurers reimburse hospitals well below what was charged.
Patients covered by commercial insurance products have negotiated rates with hospitals. Patients covered by Medicare or Medicaid programs have hospital reimbursement rates determined by federal and state governments.
Hospital charges may include bundled procedures, personnel, services and supplies. An example would be room rates that include the space, equipment, nursing personnel and supplies.
When a patient has the opportunity to shop for medical services, the patient should contact the insurer to understand which costs will be covered and which will be the patient’s responsibility.
You can check our standard charges here.
Patients should contact Norton Healthcare directly for any further details.
For hospital procedure price quotes
Call (502) 272-5330.
You will be asked to provide the 5-digit CPT code for the procedure you are asking about.
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