Standard Charges
Each hospital is required to make available to the public a list of the
hospital’s current standard charges.
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Patients also have rights and protections against surprise medical bills. Click
here for more information.
Facts regarding hospital pricing
Please remember that in addition to the list of standard charges, additional
information is necessary to fully understand how and why hospitals price
certain services. The following information is helpful in explaining charges:
General Facts:
- Hospital charge data is being provided as part of a federal regulatory
policy mandated by the U.S. Department of Health & Human Services
and Centers for Medicare & Medicaid Services.
- Hospital charge data is not representative of a patient’s expected
out-of-pocket costs. Because each patient’s case is different based
on specific medical conditions, the actual amount owed by a patient will
depend on that patient’s insurance coverage.
- Hospital charge data is the amount a hospital bills an insurer for a service.
In the vast majority of cases, however, hospitals are reimbursed by insurance
companies and Medicare/Medicaid at a rate that is considerably less than
the amount charged.
- Patients should talk with their insurance provider to understand which
costs will be covered, and which will be the patient’s responsibility.
- Hospital charges can include unlisted procedures, services, supplies, and
tests as well as any fees associated with services, such as equipment
fees and room charges.
Facility Charges vs. Patient Out-of-Pocket Financial Obligations
The amount a facility bills for a patient’s care is known as the
“charge.” This is not the same as the actual cost or amount
paid for the care. The amount collected by a hospital for each service
is almost always less than the amount billed.
Differences in charges across hospitals
There are many reasons that charges may differ among hospitals. Among them
are the following: payer mix, facility cost structures, new technology,
staffing costs, intensity of care, range of services provided, service
frequency, documentation, capital expenses.
If you have questions about your hospital bill, please contact HCHC’s
Patient Financial Services at
319-385-6142.
